Provider Demographics
NPI:1992445878
Name:PATHERSHALL, JULIANNE RENEE
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:RENEE
Last Name:PATHERSHALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIANNE
Other - Middle Name:
Other - Last Name:STUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:77 MILL ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-4598
Mailing Address - Country:US
Mailing Address - Phone:413-572-4111
Mailing Address - Fax:413-527-4117
Practice Address - Street 1:77 MILL ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-4598
Practice Address - Country:US
Practice Address - Phone:413-572-4111
Practice Address - Fax:413-527-4117
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor