Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 10738 | MA |
NPI | 1801138797 |
---|---|
Provider Name | Mrs. Sofia Claudia Vecchio-Von Stange |
First Address | Westfield, MA 01085-4548 |
Second Address | Springfield, MA 01109-4104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2013 |
Last Update Date | 19/03/2013 |