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NPI Code Detail

MEDICARE: DR. SHELBY LOUISE HYVONEN PSY.D.

MEDICARE: DR. SHELBY LOUISE HYVONEN PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist10153MA

General Provider Information

NPI Number : 1356324354
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHELBY LOUISE HYVONEN PSY.D.
Provider Business Mailing Address
First Line : 3300 MAIN ST STE 4A
Second Line :
City : SPRINGFIELD
State : MA
Zip : 01199-1001
Country : US
Telephone Number : 413-794-1038
Fax Number : 413-794-7416
Provider Business Practice Location Address
First Line : 3300 MAIN ST STE 4A
Second Line :
City : SPRINGFIELD
State : MA
Zip : 01199-1001
Country : US
Telephone Number : 413-794-1038
Fax Number : 413-794-7416
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 11/04/2016

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