Provider Demographics
NPI:1689889784
Name:HARTBLAY, MARIAN CHRISTINE (MAT, MED)
Entity Type:Individual
Prefix:MS
First Name:MARIAN
Middle Name:CHRISTINE
Last Name:HARTBLAY
Suffix:
Gender:F
Credentials:MAT, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 VAN METER DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1430
Mailing Address - Country:US
Mailing Address - Phone:413-549-1904
Mailing Address - Fax:
Practice Address - Street 1:45 ROUND HILL RD
Practice Address - Street 2:CLARKE SCHOOL FOR THE DEAF
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2123
Practice Address - Country:US
Practice Address - Phone:413-584-3450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA293014222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist