Provider Demographics
NPI:1568870178
Name:EMMONDS, LOREEN MARION (MED)
Entity Type:Individual
Prefix:MRS
First Name:LOREEN
Middle Name:MARION
Last Name:EMMONDS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 PONTOOSIC RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-4625
Mailing Address - Country:US
Mailing Address - Phone:413-572-9975
Mailing Address - Fax:413-572-9975
Practice Address - Street 1:108 N MAIN ST UNIT A
Practice Address - Street 2:
Practice Address - City:SUNDERLAND
Practice Address - State:MA
Practice Address - Zip Code:01375-9502
Practice Address - Country:US
Practice Address - Phone:413-665-8717
Practice Address - Fax:413-665-9383
Is Sole Proprietor?:No
Enumeration Date:2014-07-27
Last Update Date:2014-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator