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Individual

EZEQUIEL LUIS FERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
119 EAST ST, SPRINGFIELD, MA 01104
(413) 657-0759
Mailing address
119 EAST ST, SPRINGFIELD, MA 01104-1551
(413) 657-0759

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
05/13/2018
Last updated
05/22/2018
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Product
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  • EDI platform