Provider Demographics
NPI:1457669632
Name:LESSARD, RONALD JR
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:LESSARD
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-2772
Mailing Address - Country:US
Mailing Address - Phone:781-321-3038
Mailing Address - Fax:
Practice Address - Street 1:64 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-2772
Practice Address - Country:US
Practice Address - Phone:781-321-3038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor