Healthcare Provider Details

I. General information

NPI: 1457835936
Provider Name (Legal Business Name): SANDRA DELGADO PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2018
Last Update Date: 09/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MAIN ST.
STOCKBRIDGE MA
01262-0962
US

IV. Provider business mailing address

PO BOX 282
WEST STOCKBRIDGE MA
01266-0282
US

V. Phone/Fax

Practice location:
  • Phone: 413-931-5831
  • Fax:
Mailing address:
  • Phone: 202-277-5218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number10803
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: