Provider Demographics
NPI:1760818744
Name:MARTIN-TOUSIGNANT, BRENDA GAYLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:GAYLE
Last Name:MARTIN-TOUSIGNANT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MS
Other - First Name:BRENDA
Other - Middle Name:GAYLE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:189 BIRCH BLUFFS DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-4808
Mailing Address - Country:US
Mailing Address - Phone:413-977-2379
Mailing Address - Fax:
Practice Address - Street 1:112 WATER ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-4206
Practice Address - Country:US
Practice Address - Phone:617-315-8856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3843103T00000X
MA11589103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist