Individual
JOANNAH THAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 OLD LYMAN RD, SOUTH HADLEY, MA 01075-2630
(413) 536-9129
Mailing address
30 OLD LYMAN RD, SOUTH HADLEY, MA 01075-2630
(413) 536-9129
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
12/03/2015
Last updated
09/17/2019
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