Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1023175106 |
---|---|
Provider Name | Ms. Lisa Jean Wasel |
First Address | Westborough, MA 01581-1601 |
Second Address | Milford, MA 01757-1748 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 05/08/2013 |