Provider Demographics
NPI:1972892503
Name:GONYEA, GUINEVERE (COTA/L)
Entity type:Individual
Prefix:
First Name:GUINEVERE
Middle Name:
Last Name:GONYEA
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 LOWER WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-9403
Mailing Address - Country:US
Mailing Address - Phone:413-532-1100
Mailing Address - Fax:413-532-2100
Practice Address - Street 1:98 LOWER WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-9403
Practice Address - Country:US
Practice Address - Phone:413-532-1100
Practice Address - Fax:413-532-2100
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant