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General NPI Number Information
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NPI Number | 1891103511
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Entity Type | Individual
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Provider Name | LAURA O'BRIEN LCSW EMDR
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Gender | Female
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Dates
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Enumeration Date | 07/25/2014
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 9 VILLAGE INN RD
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City | WESTMINSTER
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State | MA
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Zip | 01473-1643
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Country | US
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Telephone | 720-917-9072
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Fax |
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Provider Business Mailing Address
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Address Line | 45 EVERS ST
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City | WORCESTER
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State | MA
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Zip | 01603-2231
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Country | US
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Telephone | 508-769-3705
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 886622289
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License Number State | MA
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