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Individual

DR. MARC CONRAD LAQUERRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
120 MAIN ST, SUITE 103, NASHUA, NH 03060-2707
(603) 345-3786
Mailing address
120 MAIN ST, SUITE 103, NASHUA, NH 03060-2707
(603) 345-3786

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
756
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30420513
NH
Enumeration date
07/27/2006
Last updated
07/08/2007
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