Provider Demographics
NPI:1851416788
Name:SCHERMERHORN, KATHY A (LIC AC)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:A
Last Name:SCHERMERHORN
Suffix:
Gender:F
Credentials:LIC AC
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 177
Mailing Address - Street 2:
Mailing Address - City:MONTAGUE
Mailing Address - State:MA
Mailing Address - Zip Code:01351-0177
Mailing Address - Country:US
Mailing Address - Phone:413-367-0122
Mailing Address - Fax:
Practice Address - Street 1:46 MAIN ST
Practice Address - Street 2:
Practice Address - City:MONTAGUE
Practice Address - State:MA
Practice Address - Zip Code:01351-8923
Practice Address - Country:US
Practice Address - Phone:413-367-0122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA605171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist