Individual
ALYSSA L LACOUTURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
15 BOLTON PL, BROCKTON, MA 02301-5316
(508) 427-4383
(508) 584-4328
Mailing address
15 BOLTON PL, BROCKTON, MA 02301-5316
(508) 427-4383
(508) 584-4328
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
115331
MA
Other
Enumeration date
11/06/2009
Last updated
11/06/2009
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