Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 111759 | MA |
NPI | 1003234469 |
---|---|
Provider Name | Alison Brassard L'heureux |
First Address | Northampton, MA 01060-4272 |
Second Address | Florence, MA 01062-1287 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 02/04/2014 |