Individual
KATHIUSHKA DIVALANIE BANDIAKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 791, HOLYOKE, MA 01041-0791
(413) 377-6388
(413) 533-1016
Mailing address
1205 BRADLEY RD, SPRINGFIELD, MA 01118-1828
(413) 304-1993
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/07/2024
Last updated
06/13/2024
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