Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YP1600X | Pastoral Counselor | ||
N | 1041C0700X | Clinical Social Worker | 1017526 | MA |
NPI | 1003977216 |
---|---|
Provider Name | Dr. Marie T. Sandoli |
First Address | East Brookfield, MA 01515-0665 |
Second Address | Auburn, MA 01501-2457 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 08/07/2007 |