Healthcare Provider Details
I. General information
NPI: 1720915952
Provider Name (Legal Business Name): BODY AND TOES CONSULTING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
102 CLIFTON AVE
SPRINGFIELD MA
01105-1912
US
IV. Provider business mailing address
102 CLIFTON AVE
SPRINGFIELD MA
01105-1912
US
V. Phone/Fax
- Phone: 413-218-4699
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CELIA
GOULDBOURNE-DUNKELLY
Title or Position: OWNER
Credential:
Phone: 413-218-4699