Provider Demographics
NPI:1003631979
Name:SEMEDO, HEYDYMARA T
Entity type:Individual
Prefix:
First Name:HEYDYMARA
Middle Name:T
Last Name:SEMEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 FROST LN
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-3509
Mailing Address - Country:US
Mailing Address - Phone:413-949-5910
Mailing Address - Fax:
Practice Address - Street 1:8 FROST LN
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-3509
Practice Address - Country:US
Practice Address - Phone:413-949-5910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service