Provider Demographics
NPI:1558536078
Name:WATT-ALDREDGE, LAUREL BERNADETTE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAUREL
Middle Name:BERNADETTE
Last Name:WATT-ALDREDGE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SCHOOL ST
Mailing Address - Street 2:OFFICE #5
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-7717
Mailing Address - Country:US
Mailing Address - Phone:617-650-9807
Mailing Address - Fax:
Practice Address - Street 1:40 SCHOOL ST
Practice Address - Street 2:OFFICE #5
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-7717
Practice Address - Country:US
Practice Address - Phone:617-650-9807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8784103TC0700X
103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth