Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 2016002034 | MA |
NPI | 1033585484 |
---|---|
Provider Name | Hillary Leedy |
First Address | Springfield, MA 01105-1864 |
Second Address | Springfield, MA 01105-1864 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2015 |
Last Update Date | 24/06/2021 |