Provider Demographics
NPI:1548603418
Name:LABREE, WALTER J III
Entity Type:Individual
Prefix:MR
First Name:WALTER
Middle Name:J
Last Name:LABREE
Suffix:III
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 1:484 MAIN ST
Mailing Address - Street 2:SUITE 560
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608
Mailing Address - Country:US
Mailing Address - Phone:508-890-6519
Mailing Address - Fax:
Practice Address - Street 1:484 MAIN ST
Practice Address - Street 2:SUITE 560
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1893
Practice Address - Country:US
Practice Address - Phone:508-890-6519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor