Healthcare Provider Details

I. General information

NPI: 1013235837
Provider Name (Legal Business Name): SUSAN GUZIK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2010
Last Update Date: 05/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 SOUTH ST
WARE MA
01082-1616
US

IV. Provider business mailing address

37 E MAIN ST
WEST BROOKFIELD MA
01585-2906
US

V. Phone/Fax

Practice location:
  • Phone: 413-967-6241
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: