Provider Demographics
NPI:1649539388
Name:ATC TRAVELERS NURSES & ALLIED PROFESSIONALS
Entity type:Organization
Organization Name:ATC TRAVELERS NURSES & ALLIED PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:M A CCC-SLP
Authorized Official - Phone:413-575-4055
Mailing Address - Street 1:3 HATHAWAY RD
Mailing Address - Street 2:
Mailing Address - City:WESTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-9508
Mailing Address - Country:US
Mailing Address - Phone:413-575-4055
Mailing Address - Fax:
Practice Address - Street 1:3 HATHAWAY RD
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-9508
Practice Address - Country:US
Practice Address - Phone:413-575-4055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12106878314000000X
MA7148314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility