Provider Demographics
NPI:1396233862
Name:HARACKIEWICZ, ERIN LEIGH (MED)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LEIGH
Last Name:HARACKIEWICZ
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 PUTNAM HILL RD
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590-1651
Mailing Address - Country:US
Mailing Address - Phone:978-609-7501
Mailing Address - Fax:
Practice Address - Street 1:330 SW CUTOFF STE 203
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-2730
Practice Address - Country:US
Practice Address - Phone:508-341-2829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician