Individual
JULIA LACKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
22 SUMMER ST, WESTBOROUGH, MA 01581-1565
(508) 366-1717
Mailing address
22 SUMMER ST, WESTBOROUGH, MA 01581-1565
(508) 366-1717
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7858
MA
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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