Provider Demographics
NPI:1982632139
Name:HARTWELL-WALKER, MARIE R (EDD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:R
Last Name:HARTWELL-WALKER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 N WHITNEY ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1815
Mailing Address - Country:US
Mailing Address - Phone:413-575-5387
Mailing Address - Fax:413-253-7275
Practice Address - Street 1:111 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3924
Practice Address - Country:US
Practice Address - Phone:413-575-5387
Practice Address - Fax:413-253-7275
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2337103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW02507Medicare ID - Type UnspecifiedPSYCHOLOGIST