Individual
JODY LYNN PELLETIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
7 CEDAR GLN, GREENFIELD, MA 01301-2553
(413) 522-0100
Mailing address
7 CEDAR GLN, GREENFIELD, MA 01301-2553
(413) 522-0100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0
MA
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
MA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1
—
MA
Enumeration date
07/24/2020
Last updated
07/24/2020
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