Doctor Name: | BETH PRULLAGE |
NPI Number: | 1275784878 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S.W. |
License Number: | 111790 |
Business Practice Address: | 39 Union St Easthampton, MA - 010271468 |
Business Phone Number: | 4135291764 |
Business Fax Number: | 4135299047 |
Mailing Address: | 39 Union St, EASTHAMPTON |
State: | MA |
Postal Code: | 010271468 |
Phone Number: | 4135291764 |
Fax Number: | 4135299047 |
NPI Enumeration Date: | 10/01/2008 |
NPI Last Update Date: | 10/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 111790 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |