Individual
MS. LAURA GRACE MATLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
11 CHAPEL PL, WELLESLEY, MA 02481-3130
(781) 235-4950
Mailing address
16 MAGNOLIA AVE # 1, CAMBRIDGE, MA 02138-3217
(617) 686-1392
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
9366
MA
Other
Enumeration date
08/12/2008
Last updated
08/19/2011
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