Healthcare Provider Details

I. General information

NPI: 1316404569
Provider Name (Legal Business Name): ELIZABETH SCHWAIGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 BISSELL RD
WILLIAMSBURG MA
01096-9415
US

IV. Provider business mailing address

118 BISSELL RD
WILLIAMSBURG MA
01096-9415
US

V. Phone/Fax

Practice location:
  • Phone: 413-250-4362
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number10725
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: