Healthcare Provider Details

I. General information

NPI: 1306206172
Provider Name (Legal Business Name): GRAZYNA CHRABASZCZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2016
Last Update Date: 03/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 CHRISTOPHER TER
WEST SPRINGFIELD MA
01089-4521
US

IV. Provider business mailing address

11 CHRISTOPHER TER
WEST SPRINGFIELD MA
01089-4521
US

V. Phone/Fax

Practice location:
  • Phone: 413-241-4248
  • Fax:
Mailing address:
  • Phone: 413-241-4248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number3901
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: