Individual
LAURA MARIE WIECZOREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
89 ACCESS RD STE 24, NORWOOD, MA 02062-5233
(781) 551-0999
Mailing address
89 ACCESS RD STE 24, NORWOOD, MA 02062-5233
(781) 551-0999
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
OS017607
PA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
267729
MA
390200000X
Student in an Organized Health Care Education/Training Program
0T014065
PA
Other
Enumeration date
06/21/2011
Last updated
11/08/2020
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