Provider Demographics
NPI:1679634380
Name:FERRER, LAURA ALLAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ALLAN
Last Name:FERRER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 BEACON ST
Mailing Address - Street 2:STE 324
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3203
Mailing Address - Country:US
Mailing Address - Phone:781-648-4972
Mailing Address - Fax:
Practice Address - Street 1:57 BEDFORD ST
Practice Address - Street 2:SUITE 230
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4502
Practice Address - Country:US
Practice Address - Phone:781-648-4972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7567103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW50458OtherMEDICARE PTAN