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General NPI Number Information
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NPI Number | 1073884565
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Entity Type | Organization
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Legal Business Name | HAFFEY CENTER FOR ATTENTION & MEMORY
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Dates
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Enumeration Date | 01/16/2012
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Last Update Date | 01/16/2012
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Provider Practice Location Address
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Address Line | 433 WEST ST SUITE 5
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City | AMHERST
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State | MA
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Zip | 01002-2936
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Country | US
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Telephone | 413-259-1654
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Fax |
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Provider Business Mailing Address
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Address Line | 433 WEST ST SUITE 5
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City | AMHERST
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State | MA
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Zip | 01002-2936
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Country | US
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Telephone | 413-259-1654
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MARK D HAFFEY
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Credential | ED.D.
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Telephone | 413-259-1654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4415
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License Number State | MA
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