Provider Demographics
NPI:1871739359
Name:HALE, NANCY W (PHD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:W
Last Name:HALE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 EAST RD
Mailing Address - Street 2:
Mailing Address - City:ALFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01266-9728
Mailing Address - Country:US
Mailing Address - Phone:413-528-0865
Mailing Address - Fax:
Practice Address - Street 1:61 EAST RD
Practice Address - Street 2:
Practice Address - City:ALFORD
Practice Address - State:MA
Practice Address - Zip Code:01266-9728
Practice Address - Country:US
Practice Address - Phone:413-528-0865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4860103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0522945Medicare PIN