Puddingstone Place, LLC
Speech-Language Pathologist, in Middleboro, MA. Organization (NPI-2).
NPI number1477054419
StatusActive
Last updated in NPPESMar 19, 2018
Details
- NPI
- 1477054419
- Entity type
- Organization (NPI-2)
- Legal business name
- Puddingstone Place, LLC
- Organization subpart
- No
- Enumeration date
- Feb 26, 2018
- Last updated
- Mar 19, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | – | – | Yes |
| 103K00000X | Behavior Analyst | – | – | |
| 225X00000X | Occupational Therapist | – | – |
Practice location
47 E Grove St Ste 102Middleboro, MA 02346-1816
Phone 774-213-2362
Mailing address
47 E Grove St Ste 102Middleboro, MA 02346-1816
Phone 774-213-2362
Other practice locations
20 Hope Ave Ste 312
Waltham, MA 02453-2721
Waltham, MA 02453-2721
Phone 774-213-1032 · Fax 774-568-5621
Authorized official
Paul Domenic Amato
Accountant/ DO
7742132362
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