Organization
ROBERT L WING PSYD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L WING PSY D (OWNER PRESIDENT)
(413) 568-0850
Entity
Organization
Contact information
Practice address
94 N ELM ST, SUITE 205, WESTFIELD, MA 01085-1647
(413) 568-0850
(413) 562-1476
Mailing address
94 N ELM ST, SUITE 205, WESTFIELD, MA 01085-1647
(413) 568-0850
(413) 562-1476
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3254
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0513954
—
MA
01
—
17783
HEALTH NEW ENGLAND
—
01
—
W03345
BLUE CROSS BLUE SHIELD
—
Enumeration date
09/20/2005
Last updated
01/10/2008
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