Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 2616 | MA |
Y | 103TC0700X | Clinical Psychologist | 2616 | MA |
NPI | 1013067529 |
---|---|
Provider Name | Dr. Ricki Ellen Kantrowitz |
First Address | Northampton, MA 01060-1658 |
Second Address | Westfield, MA 01085-3521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 27/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13481 | HEALTH NEW ENGLAND (01) | MA |
W02764 | BLUE CROSS BLUE SHIELD (01) | MA |