Individual
LAURA A. RAFAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1601 WASHINGTON ST, BOSTON, MA 02118-1951
(617) 425-2000
Mailing address
1601 WASHINGTON ST., BOSTON, MA 02118-1951
(617) 425-2000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9999999999
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041C0700X
—
MA
Enumeration date
09/15/2011
Last updated
09/15/2011
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