Individual
KATHERINE DEZUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
819 WORCESTER ST STE 1, SPRINGFIELD, MA 01151-1056
(413) 304-2501
(413) 789-0290
Mailing address
819 WORCESTER ST STE 1, SPRINGFIELD, MA 01151-1056
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
363AM0700X
Medical Physician Assistant
Primary
PA7967
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/18/2017
Last updated
10/28/2021
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