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General NPI Number Information
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NPI Number | 1902256878
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Entity Type | Individual
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Provider Name | ASHLEY NICOLE SANTOS
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Gender | Female
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Dates
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Enumeration Date | 06/21/2016
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Last Update Date | 06/21/2016
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Provider Practice Location Address
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Address Line | 1236 MAIN ST
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City | HOLYOKE
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State | MA
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Zip | 01040-2955
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Country | US
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Telephone | 860-965-6222
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Fax |
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Provider Business Mailing Address
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Address Line | 129 KING ST
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City | NORTHAMPTON
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State | MA
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Zip | 01060-3258
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 198733486
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License Number State | CT
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