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General NPI Number Information
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NPI Number | 1265967921
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Entity Type | Individual
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Provider Name | JULIANNE WILSON LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 489 BERNARDSTON RD
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City | GREENFIELD
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State | MA
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Zip | 01301-1238
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Country | US
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Telephone | 413-512-5833
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Fax |
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Provider Business Mailing Address
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Address Line | 164 GRANBY RD
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City | SOUTH HADLEY
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State | MA
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Zip | 01075-2952
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Country | US
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Telephone | 141-323-0566
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | S39913568
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License Number State | MA
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