Provider Demographics
NPI:1386160604
Name:HEMENWAY, ALLYSON
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:HEMENWAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 DAVIDSON RD
Mailing Address - Street 2:
Mailing Address - City:CHARLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01507-1514
Mailing Address - Country:US
Mailing Address - Phone:774-573-0512
Mailing Address - Fax:
Practice Address - Street 1:42 EDWARDS ST
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-1937
Practice Address - Country:US
Practice Address - Phone:774-318-1806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst