Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 118392 | MA |
NPI | 1114408317 |
---|---|
Provider Name | Mrs. Alicia Lawless |
First Address | Stoneham, MA 02180-3843 |
Second Address | Stoneham, MA 02180-3843 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2018 |
Last Update Date | 24/08/2018 |