Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003109273 |
---|---|
Provider Name | Sonya Pelletier |
First Address | Salem, MA 01970-5529 |
Second Address | Salem, MA 01970-5529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2011 |
Last Update Date | 20/05/2011 |