Individual
DR. JUDITH PARKER LEAVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
35 MAIN ST, WAYLAND, MA 01778-5037
(508) 653-8874
Mailing address
35 MAIN ST, WAYLAND, MA 01778-5037
(508) 653-8874
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2973
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2973
STATE LICENSE
MA
Enumeration date
11/20/2006
Last updated
07/08/2007
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