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Organization
LAURIE E HERZOG PHD PC
Active
Organization
LAURIE E HERZOG PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURIE E. HERZOG PH.D. (PRESIDENT)
(413) 586-7774
Entity
Organization
Contact information
Practice address
155 MAIN ST, NORTHAMPTON, MA 01060-3259
(413) 586-7774
Mailing address
155 MAIN ST, NORTHAMPTON, MA 01060-3259
(413) 586-7774
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1015410
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548317274
NPI TYPE 1
MA
01
—
P04562
MEDICARE PTAN
MA
Enumeration date
12/27/2013
Last updated
08/25/2014
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