Individual
JACQUELINE A STORES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
120 SOUTH ST, PITTSFIELD, MA 01201-6110
(413) 448-8302
Mailing address
120 SOUTH ST, PITTSFIELD, MA 01201-6110
(413) 448-8302
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7340
MA
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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