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General NPI Number Information
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NPI Number | 1306612312
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Entity Type | Individual
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Provider Name | ISABELLA S. GUAJARDO-MOORE BA
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Gender | Female
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Dates
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Enumeration Date | 11/30/2023
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 395 LIBERTY ST
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City | SPRINGFIELD
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State | MA
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Zip | 01104-3779
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Country | US
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Telephone | 413-310-1243
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Fax |
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Provider Business Mailing Address
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Address Line | 73 FOXRIDGE RD
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City | WEST HARTFORD
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State | CT
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Zip | 06107-3625
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Country | US
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Telephone | 860-948-0963
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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