Individual
AMANDA LISSNER BERGQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
303 BEECH ST, HOLYOKE, MA 01040-3968
(413) 540-1155
Mailing address
511 MAIN ST, HAMPDEN, MA 01036-9640
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5000774
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851444616
RIVER VALLEY COUNSELING CENTER
MA
Enumeration date
07/10/2019
Last updated
04/05/2024
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