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NPI Code Detail

MEDICARE: DR. LAURIE L CHARLES PH.D.

MEDICARE: DR. LAURIE L CHARLES PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist1312MA

General Provider Information

NPI Number : 1073791018
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURIE L CHARLES PH.D.
Provider Business Mailing Address
First Line : 147 PELHAM ST
Second Line :
City : METHUEN
State : MA
Zip : 01844-2060
Country : US
Telephone Number : 978-683-3491
Fax Number : 978-683-3058
Provider Business Practice Location Address
First Line : 147 PELHAM ST
Second Line :
City : METHUEN
State : MA
Zip : 01844-2060
Country : US
Telephone Number : 978-683-3491
Fax Number : 978-683-3058
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2008
Last Update Date : 07/21/2022

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Directions to “ DR. LAURIE L CHARLES PH.D.” Practice Location

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