Individual
DR. MARY ELLEN LAWLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
464 GLEN ST, GLENS FALLS, NY 12801-2925
(518) 792-7927
Mailing address
464 GLEN ST, GLENS FALLS, NY 12801-2925
(518) 792-7927
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
10781
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01243365
—
NY
Enumeration date
04/25/2007
Last updated
06/24/2010
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