Healthcare Provider Details

I. General information

NPI: 1568870178
Provider Name (Legal Business Name): LOREEN MARION EMMONDS M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2014
Last Update Date: 07/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N MAIN ST UNIT A
SUNDERLAND MA
01375-9502
US

IV. Provider business mailing address

145 PONTOOSIC RD
WESTFIELD MA
01085-4625
US

V. Phone/Fax

Practice location:
  • Phone: 413-665-8717
  • Fax: 413-665-9383
Mailing address:
  • Phone: 413-572-9975
  • Fax: 413-572-9975

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: