Individual
JANITA VANDERWALT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 FENN ST, BRIEN CENTER, PITTSFIELD, MA 01201-6278
(413) 629-1253
Mailing address
1 FENN ST, BRIEN CENTER, PITTSFIELD, MA 01201-6278
(413) 629-1253
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/14/2008
Last updated
08/14/2008
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