Individual
LOIS JEAN KEITHLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
68 LEONARD ST, BELMONT, MA 02478-2522
(781) 641-0457
Mailing address
29 VALLEY RD, ARLINGTON, MA 02476-7831
(781) 641-0457
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3853
MA
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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