Individual
DR. LESLIE KJOSA SUTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
41 PACELLA PARK DR, RANDOLPH, MA 02368-1755
(781) 437-1250
Mailing address
41 PACELLA PARK DR, RANDOLPH, MA 02368-1755
(781) 437-1250
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
8871
MA
103TS0200X
School Psychologist
8871
MA
Other
Enumeration date
08/08/2008
Last updated
08/08/2008
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