Provider Demographics
NPI:1073069142
Name:NAVARRETE, VERONICA M (PHD, MS, PA)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:M
Last Name:NAVARRETE
Suffix:
Gender:F
Credentials:PHD, MS, PA
Other - Prefix:DR
Other - First Name:VERONICA
Other - Middle Name:NAVARRETE
Other - Last Name:OLAVARRIETA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:19 MILFORD ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1332
Mailing Address - Country:US
Mailing Address - Phone:413-781-3727
Mailing Address - Fax:413-734-8192
Practice Address - Street 1:19 MILFORD ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1332
Practice Address - Country:US
Practice Address - Phone:413-781-3727
Practice Address - Fax:413-734-8192
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2021-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXLPA4001871OtherTX PSYCHOLOGICAL ASSOCIATION
MA1553688OtherCOMMONWEALTH OF MA - SEC OFFICE
MA0512257Medicaid
430342935OtherUS FED GOV