Individual
CAROL LESLEY MACKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 MAIN ST, STURBRIDGE, MA 01566-1481
(508) 960-7830
Mailing address
54 OAKES AVE, SOUTHBRIDGE, MA 01550-4012
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
221700000X
Art Therapist
9440
MA
Other
Enumeration date
03/19/2013
Last updated
07/10/2024
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