Doctor Name: | MS. PAMELA J MINICHIELLO |
NPI Number: | 1063567055 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS |
License Number: | |
Business Practice Address: | 56 Framingham Rd Marlborough, MA - 017523260 |
Business Phone Number: | 5084818077 |
Business Fax Number: | 5084816680 |
Mailing Address: | 5 Old Village Rd, ACTON |
State: | MA |
Postal Code: | 017204610 |
Phone Number: | 5084818077 |
Fax Number: | 5084816680 |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 07/08/2007 |
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: |