Individual
JUDITH S. NISSENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
1109 GRANBY RD, CHICOPEE, MA 01020-1568
(413) 523-0900
(413) 523-0901
Mailing address
1109 GRANBY RD, CHICOPEE, MA 01020-1568
(413) 523-0900
(413) 523-0901
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3991
MA
Other
Enumeration date
08/03/2006
Last updated
02/23/2012
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