Individual
ELIZABETH LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 BURLINGTON RD, BEDFORD, MA 01730-1406
(978) 761-5098
Mailing address
205 BURLINGTON RD, BEDFORD, MA 01730-1406
(978) 761-5098
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000023532
BMC
MA
01
—
042611055
TAX ID
MA
01
—
1004745
NHP
MA
01
—
1303287
MBHP
MA
01
—
99618201
NETWORK HEATH
MA
01
—
M18633
BCBS
MA
Enumeration date
04/03/2014
Last updated
03/11/2019
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