# THOM MYSTIC VALLEY EARLY INTERVENTION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710159116
- **Authorized official:** MS. PATRICIA ANN MCCARTHY OTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (978) 302-0802

## Contact information

- **Practice address:** 11 COLUMBIA RD, WAKEFIELD, MA 01880
- **Practice address phone:** (978) 302-0802
- **Mailing address:** 11 COLUMBIA RD, UNIT 4, WAKEFIELD, MA 01880-3339
- **Mailing address phone:** (978) 302-0802

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 8130 | MA | Yes |

## Other

- **Enumeration date:** 03/26/2008
- **Last updated:** 03/26/2008