Individual
DR. LAURA EMILY DE LA TORRE BUENO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
21 SPRING HILL TER, SOMERVILLE, MA 02143-1514
(617) 776-8679
(617) 623-1234
Mailing address
21 SPRING HILL TER, SOMERVILLE, MA 02143-1514
(617) 776-8679
(617) 623-1234
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6112
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005781235
AETNA
MA
01
—
V352G
EMPIRE BLUE CROSS BLUE SH
NY
Enumeration date
11/14/2005
Last updated
07/09/2007
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