Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003054958 |
---|---|
Provider Name | Bernadette St George |
First Address | Haydenville, MA 01039-9757 |
Second Address | Northampton, MA 01060-4272 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2009 |
Last Update Date | 07/03/2014 |