Provider Demographics
NPI:1528592425
Name:GUITY, TATIANA
Entity Type:Individual
Prefix:
First Name:TATIANA
Middle Name:
Last Name:GUITY
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:PO BOX 4219
Mailing Address - Street 2:ADMINISTRATIVE OFFICES
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01202-4219
Mailing Address - Country:US
Mailing Address - Phone:413-629-1262
Mailing Address - Fax:413-448-2198
Practice Address - Street 1:359 FENN ST
Practice Address - Street 2:ADMINISTRATIVE OFFICES
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-5261
Practice Address - Country:US
Practice Address - Phone:413-629-1262
Practice Address - Fax:413-448-2198
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor