Individual
DR. JUDITH WILNER LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1577 BEACON ST, BROOKLINE, MA 02446-4602
(617) 739-1212
(617) 731-8585
Mailing address
1577 BEACON ST, BROOKLINE, MA 02446-4602
(617) 739-1212
(617) 731-8585
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7154
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7154
STATE PSYCHOLOGY LICENSE
MA
01
—
W05753
BCBS PIN
MA
Enumeration date
01/24/2007
Last updated
07/08/2007
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