Provider Demographics
NPI:1164822581
Name:WYSZYNSKI, RACHEL (MS)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WYSZYNSKI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PEARL DR
Mailing Address - Street 2:
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-2418
Mailing Address - Country:US
Mailing Address - Phone:413-949-0890
Mailing Address - Fax:
Practice Address - Street 1:540 VFW PKWY
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-1332
Practice Address - Country:US
Practice Address - Phone:617-325-2993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health