Individual
DR. LAURA SEELY DERR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1017 TURNPIKE ST., SUITE 12C, CANTON, MA 02021-2847
(781) 713-4707
(781) 713-4708
Mailing address
30 NEPONSET AVE, ROSLINDALE, MA 02131-2123
(781) 713-4707
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6680
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0524069
—
MA
01
—
798610
TUFTS HMO
MA
01
—
W05804
BCBS HMO PPO FEDERAL
MA
Enumeration date
07/11/2006
Last updated
08/10/2020
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