MEDICARE: MARYJO TURGEON

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
1	101YM0800X	Mental Health Counselor	S91385056	MA

General Provider Information

NPI Number	:	1679024053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYJO TURGEON

Provider Business Mailing Address
First Line	:	206 JAMAICA ST
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01119-1807
Country	:	US
Telephone Number	:	413-313-2379
Fax Number	:

Provider Business Practice Location Address
First Line	:	206 JAMAICA ST
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01119-1807
Country	:	US
Telephone Number	:	413-313-2379
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2016
Last Update Date	:	10/20/2016

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Directions to “ MARYJO TURGEON ” Practice Location

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