Individual
MS. JOHANNE THEODAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
605 STATE ST, SPRINGFIELD, MA 01109-4114
(413) 266-2202
(413) 301-5164
Mailing address
605 STATE ST, SPRINGFIELD, MA 01109-4114
(413) 266-2202
(413) 301-5164
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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