Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 6351 | MA |
Y | 102L00000X | Psychologist | 10466 | MA |
Y | 103T00000X | Psychologist | 10466 | MA |
NPI | 1013089515 |
---|---|
Provider Name | David J Wehry |
First Address | Pittsfield, MA 01201-6442 |
Second Address | Pittsfield, MA 01201-6442 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 10/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
34687 | HEALTH NEW ENGLAND (01) | MA |