Basic Information
| Provider Information | |||||||||
| NPI: | 1912384470 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLAHERTY | ||||||||
| FirstName: | ANNE | ||||||||
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| Credential: | M.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 172 SUMMER ST | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | AMHERST | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010021124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137390882 | ||||||||
| FaxNumber: | 4137815729 | ||||||||
| Practice Location | |||||||||
| Address1: | 130 MAPLE STREET | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137390882 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2015 | ||||||||
| LastUpdateDate: | 05/04/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.