Doctor Name: | JAYNE FARRELL |
NPI Number: | 1164743654 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 4209 |
Business Practice Address: | 628 Center St Chicopee, MA - 010131589 |
Business Phone Number: | 4137460051 |
Business Fax Number: | |
Mailing Address: | 125 N Elm St, WESTFIELD |
State: | MA |
Postal Code: | 010851643 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/18/2010 |
NPI Last Update Date: | 06/18/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 4209 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |