Doctor Name: | KIMBERLY J LORD |
NPI Number: | 1003249889 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BSW |
License Number: | |
Business Practice Address: | 1 Arch Pl Greenfield, MA - 013012457 |
Business Phone Number: | 4137741000 |
Business Fax Number: | |
Mailing Address: | 11 Sylvan Dr, WILBRAHAM |
State: | MA |
Postal Code: | 010952735 |
Phone Number: | 4137741000 |
Fax Number: | |
NPI Enumeration Date: | 08/15/2013 |
NPI Last Update Date: | 08/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |