Individual
MITCHELL I CLIONSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
155 MAPLE STREET, SUITE 203, SPRINGFIELD, MA 01105-1828
(413) 734-3331
(413) 739-1652
Mailing address
155 MAPLE STREET, SUITE 203, SPRINGFIELD, MA 01105-1828
(413) 734-3331
(413) 739-1652
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2113
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11365
HEALTH NEW ENGLAND
—
01
—
5024760
CHAMPUS
—
01
—
734079
TUFTS
—
01
—
W02301
BCBS OF MA
—
Enumeration date
12/05/2006
Last updated
07/08/2007
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