Individual
LAUREN R BLAKELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
96 FAIRBANKS AVE, WELLESLEY, MA 02481-5256
(617) 877-6294
Mailing address
96 FAIRBANKS AVE, WELLESLEY, MA 02481-5256
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
7834
MA
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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