Provider Demographics
NPI:1285839464
Name:SHANLEY, LAUREEN T (MED)
Entity Type:Individual
Prefix:MISS
First Name:LAUREEN
Middle Name:T
Last Name:SHANLEY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
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Mailing Address - Street 1:10 COUNTRY HILL LN
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-1269
Mailing Address - Country:US
Mailing Address - Phone:978-387-7431
Mailing Address - Fax:
Practice Address - Street 1:15 UNION ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1866
Practice Address - Country:US
Practice Address - Phone:978-688-5222
Practice Address - Fax:978-688-4901
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health