Individual
JEFFREY JOSHUA TITLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
491 MAIN ST, SUITE NUMBER 5, GREAT BARRINGTON, MA 01230-1822
(413) 528-5155
Mailing address
491 MAIN ST, SUITE NUMBER 5, GREAT BARRINGTON, MA 01230-1822
(413) 528-5155
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
611
NH
103T00000X
Psychologist
Primary
873
MA
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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