Healthcare Provider Details

I. General information

NPI: 1184772378
Provider Name (Legal Business Name): ELIZABETH A UMLAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 SHELBURNE RD
GREENFIELD MA
01301-9622
US

IV. Provider business mailing address

18 SPRUCE ST
GREENFIELD MA
01301-1613
US

V. Phone/Fax

Practice location:
  • Phone: 413-774-1000
  • Fax: 413-774-1197
Mailing address:
  • Phone: 413-775-1589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: