Provider Demographics
NPI:1841017233
Name:GUILLEMETTE, ANGELA LEIGH (BS, MS, PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LEIGH
Last Name:GUILLEMETTE
Suffix:
Gender:F
Credentials:BS, MS, PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:230 MAPLE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-5140
Mailing Address - Country:US
Mailing Address - Phone:413-420-6210
Mailing Address - Fax:413-533-4751
Practice Address - Street 1:230 MAPLE ST STE 1
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-5140
Practice Address - Country:US
Practice Address - Phone:413-420-6210
Practice Address - Fax:413-533-4571
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH233575183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist