Provider Demographics
NPI:1043495468
Name:LAUZON, MARY (MA)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:LAUZON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3123
Mailing Address - Country:US
Mailing Address - Phone:401-766-0900
Mailing Address - Fax:401-767-4099
Practice Address - Street 1:8 COURT ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-4402
Practice Address - Country:US
Practice Address - Phone:401-766-0900
Practice Address - Fax:401-767-4099
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health