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General NPI Number Information
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NPI Number | 1952467011
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Entity Type | Individual
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Provider Name | LAURIE S TRAFICONTE M.S.W.
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Gender | Female
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Dates
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Enumeration Date | 12/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 50 TRAPELO RD
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City | BELMONT
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State | MA
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Zip | 02478-4447
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Country | US
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Telephone | 617-926-5448
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Fax | 617-926-5448
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Provider Business Mailing Address
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Address Line | 23 GRENVILLE RD
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City | WATERTOWN
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State | MA
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Zip | 02472-4917
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Country | US
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Telephone | 617-926-1086
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Fax | 617-926-5448
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 104497
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License Number State | MA
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