Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003354887 |
---|---|
Provider Name | Quintin Sumpter |
First Address | Pittsfield, MA 01201-5261 |
Second Address | Pittsfield, MA 01201-5261 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2017 |
Last Update Date | 01/02/2017 |