Individual
POLLY FIVEASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
193 LOCUST ST, NORTHAMPTON, MA 01060-2056
(413) 584-8700
Mailing address
77 STRAW AVE, FLORENCE, MA 01062-1423
(617) 953-1860
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN265483
MA
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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