Amanda Lissner Bergquist
Counselor, Mental Health in Holyoke, MA. Individual provider (NPI-1).
NPI number1164074241
StatusActive
Last updated in NPPESApr 5, 2024
Details
- NPI
- 1164074241
- Entity type
- Individual (NPI-1)
- Name
- Amanda Lissner Bergquist
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 10, 2019
- Certification date
- Apr 5, 2024
- Last updated
- Apr 5, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 5000774 | MA | Yes |
Practice location
303 Beech StHolyoke, MA 01040-3968
Phone 413-540-1155
Mailing address
511 Main StHampden, MA 01036-9640
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