Self

NPI #1568814390 in Springfield, Massachusetts

Provider Information

NPI Number
1568814390
Entity Type
Organization
Organization Name
Self
Primary Specialty
Clinic/Center - Adolescent and Children Mental Health
Enumeration Date
Jul 5, 2016
Last Updated
Jul 5, 2016

Practice Location

Address
19 MERRICK AVE APT 1
ZIP Code
01109-4324
Phone
(413) 244-5624

Authorized Official

Name
LUIS RIVERA
Title
COUNSELOR
Phone
(413) 244-5624

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Adolescent and Children Mental HealthAdolescent and Children Mental Health

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