Provider Demographics
NPI:1164606844
Name:EHRET, JOANNE G (LIC AC)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:G
Last Name:EHRET
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1444
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-1444
Mailing Address - Country:US
Mailing Address - Phone:413-586-9594
Mailing Address - Fax:
Practice Address - Street 1:53 GOTHIC ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3047
Practice Address - Country:US
Practice Address - Phone:413-586-9594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist