Provider Demographics
NPI:1245609528
Name:GETCHELL, BRUNNIE (MED)
Entity Type:Individual
Prefix:MS
First Name:BRUNNIE
Middle Name:
Last Name:GETCHELL
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MS
Other - First Name:BRUNHILDA
Other - Middle Name:
Other - Last Name:GETCHELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED
Mailing Address - Street 1:204 CENTER ST
Mailing Address - Street 2:#13
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-2650
Mailing Address - Country:US
Mailing Address - Phone:781-294-7976
Mailing Address - Fax:
Practice Address - Street 1:50 ALDRIN RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4827
Practice Address - Country:US
Practice Address - Phone:508-830-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health