Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 9491 | MA |
N | 1041C0700X | Clinical Social Worker | 115087 | MA |
NPI | 1083856702 |
---|---|
Provider Name | Ms. Annemarie Gockel |
First Address | Northampton, MA 01060-3047 |
Second Address | Northampton, MA 01060-3047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2009 |
Last Update Date | 05/10/2016 |