Provider Demographics
NPI:1386814242
Name:KOLCHIN, MARJORIE J (LIC AC)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:J
Last Name:KOLCHIN
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 1:16 CENTER ST
Mailing Address - Street 2:SUITE #518
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3031
Mailing Address - Country:US
Mailing Address - Phone:413-584-0421
Mailing Address - Fax:
Practice Address - Street 1:16 CENTER ST
Practice Address - Street 2:SUITE 518
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3031
Practice Address - Country:US
Practice Address - Phone:413-584-0421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist