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Individual

OLIVIA LASALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
105 VICTORY RD, DORCHESTER, MA 02122-3518
(617) 371-3010
Mailing address
1426 WARSON OAKS CT, SAINT LOUIS, MO 63122-1660
(314) 698-3155

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
NY

Other

Enumeration date
09/01/2021
Last updated
09/01/2021
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