Provider Demographics
NPI:1003273319
Name:ZELGOWSKI, BRITTANY (PSYD)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:ZELGOWSKI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-2010
Mailing Address - Country:US
Mailing Address - Phone:413-748-7698
Mailing Address - Fax:413-827-8231
Practice Address - Street 1:80 STATE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-2010
Practice Address - Country:US
Practice Address - Phone:413-748-7698
Practice Address - Fax:413-827-8231
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9665103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical