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Individual

JASON ERIC LAURIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, LMFT

Contact information

Practice address
24 SALT POND RD, SUITE H3, WAKEFIELD, RI 02879-4314
(401) 864-8756
Mailing address
24 SALT POND RD, SUITE H3, WAKEFIELD, RI 02879-4314
(401) 864-8756

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT00128
RI

Other

Enumeration date
08/26/2009
Last updated
03/13/2012
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