Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 384086 | MA |
NPI | 1073896973 |
---|---|
Provider Name | Andrea Depatie |
First Address | Southbridge, MA 01550-1386 |
Second Address | Southbridge, MA 01550-1386 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2011 |
Last Update Date | 27/09/2011 |