Individual
BREANNA WARDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 MAPLE ST STE 110, SPRINGFIELD, MA 01105
(413) 732-7419
Mailing address
345 GREENWOOD ST STE A, WORCESTER, MA 01607-1767
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/26/2018
Last updated
08/11/2018
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