Provider Demographics
NPI:1760533467
Name:LAMORA, ROGER A (EDD)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:A
Last Name:LAMORA
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 TEMPLE ST UNIT 5
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-3231
Mailing Address - Country:US
Mailing Address - Phone:603-582-8075
Mailing Address - Fax:
Practice Address - Street 1:11 S STATION ST UNIT 5
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-4534
Practice Address - Country:US
Practice Address - Phone:781-934-6460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH165103TC0700X
MA3453103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical