Individual
MS. ELODIE LEONA SAMMARCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S. ED
Contact information
Practice address
1111 ELM ST, SUITE 1, WEST SPRINGFIELD, MA 01089-1540
(413) 734-0300
(781) 551-9880
Mailing address
1111 ELM ST, SUITE 1, WEST SPRINGFIELD, MA 01089-1540
(413) 734-0300
(781) 551-9880
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
4665
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1803204
—
MA
01
—
617927
TUFTS
MA
01
—
E10021
BLUE CROSS
MA
Enumeration date
07/13/2010
Last updated
07/13/2010
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