Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003108390 |
---|---|
Provider Name | Ms. Alycia Felton |
First Address | Springfield, MA 01103-1348 |
Second Address | Springfield, MA 01103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2011 |
Last Update Date | 05/05/2011 |