Provider Demographics
NPI:1477119295
Name:DRISCOLL-HURT, MEGAN KATHERINE
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:KATHERINE
Last Name:DRISCOLL-HURT
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 1:6 WOODMONT ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-2344
Mailing Address - Country:US
Mailing Address - Phone:413-313-6934
Mailing Address - Fax:
Practice Address - Street 1:6 WOODMONT ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-2344
Practice Address - Country:US
Practice Address - Phone:413-313-6934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst