Organization
IVELISSE VICENTE LICSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVELISSE VICENTE LICSW (PSYCHOTHERAPIST)
(413) 377-0677
Entity
Organization
Contact information
Practice address
62 LEONA AVE, CHICOPEE, MA 01013-3319
(413) 377-0677
Mailing address
PO BOX 1086, CHICOPEE, MA 01021-1086
(413) 377-0677
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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