Healthcare Provider Details

I. General information

NPI: 1558737064
Provider Name (Legal Business Name): SANDRA GUARRERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 BATCHELOR ST
GRANBY MA
01033-9729
US

IV. Provider business mailing address

105 BATCHELOR ST
GRANBY MA
01033-9729
US

V. Phone/Fax

Practice location:
  • Phone: 413-427-6732
  • Fax:
Mailing address:
  • Phone: 413-467-1264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number126843
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number222424
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: