Healthcare Provider Details

I. General information

NPI: 1215180773
Provider Name (Legal Business Name): ARACELIS M ECHEVARRIA M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 CHESTNUT ST
SPRINGFIELD MA
01103-1100
US

IV. Provider business mailing address

470 MEMORIAL DR APT 239
CHICOPEE MA
01020-5040
US

V. Phone/Fax

Practice location:
  • Phone: 413-313-5913
  • Fax:
Mailing address:
  • Phone: 787-205-1352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2970
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: