Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 9665 | MA |
Y | 103TC0700X | Clinical Psychologist | 9665 | MA |
NPI | 1003273319 |
---|---|
Provider Name | Brittany Zelgowski |
First Address | Springfield, MA 01103-2010 |
Second Address | Springfield, MA 01103-2010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2016 |
Last Update Date | 19/01/2016 |