Individual
AMANDA HALEY BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
203 EAST ST, EASTHAMPTON, MA 01027-1234
(413) 529-7777
Mailing address
203 EAST ST, EASTHAMPTON, MA 01027-1234
(413) 529-7777
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042680339
MASS HEALTH
MA
Enumeration date
09/25/2017
Last updated
07/21/2022
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