Provider Demographics
NPI:1306206172
Name:CHRABASZCZ, GRAZYNA
Entity Type:Individual
Prefix:
First Name:GRAZYNA
Middle Name:
Last Name:CHRABASZCZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CHRISTOPHER TER
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-4521
Mailing Address - Country:US
Mailing Address - Phone:413-241-4248
Mailing Address - Fax:
Practice Address - Street 1:11 CHRISTOPHER TER
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-4521
Practice Address - Country:US
Practice Address - Phone:413-241-4248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3901224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant