Healthcare Provider Details

I. General information

NPI: 1861616849
Provider Name (Legal Business Name): KATHY JANE MORRISSETTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MARSHALL ST BRIEN CENTER
NORTH ADAMS MA
01247-2451
US

IV. Provider business mailing address

141 FRIEND ST
ADAMS MA
01220-1439
US

V. Phone/Fax

Practice location:
  • Phone: 413-398-1341
  • Fax:
Mailing address:
  • Phone: 413-743-7254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: