Individual
TIMOTHY LAVIGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115
(617) 355-4563
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
0810006033
VA
103TC0700X
Clinical Psychologist
Primary
11931
MA
103TC0700X
Clinical Psychologist
3792
CT
Other
Enumeration date
02/03/2017
Last updated
10/14/2022
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