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NPI 1336453042

NPI 1336453042 : LAURA RICHARDSON : SPRINGFIELD, MA

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General NPI Number Information
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    NPI Number           |    1336453042
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    Entity Type          |    Individual 
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    Provider Name        |    LAURA RICHARDSON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/05/2010
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    Last Update Date     |    08/05/2010
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Provider Practice Location Address
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    Address Line         |    235 CHESTNUT ST 
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    City                 |    SPRINGFIELD
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    State                |    MA
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    Zip                  |    01103-1100
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    Country              |    US
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    Telephone            |    413-734-4978
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    23 CRAIG DR 
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    City                 |    WEST SPRINGFIELD
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    State                |    MA
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    Zip                  |    01089-4707
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    Country              |    US
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    Telephone            |    413-244-6684
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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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