Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0700X | Adult Development & Aging Psychologist | 8525 | MA |
N | 103G00000X | Clinical Psychologist | 8525 | MA |
N | 103TC0700X | Clinical Psychologist | 8525 | MA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 8525 | MA |
NPI | 1831211853 |
---|---|
Provider Name | Marie Lamto |
First Address | Cambridge, MA 02139-3072 |
Second Address | Cambridge, MA 02139-3072 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 10/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
60054 | CHICKERING (01) | MA |
7987851 | AETNA (01) | MA |
W06567 | BCBS (01) | |
W06567 | BCBS MASSACHUSETTS (01) | MA |