Individual
COURTNEY MAULEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(508) 559-0473
Mailing address
11 BURNEY ST, APARTMENT 3, BOSTON, MA 02120-2903
(732) 895-6502
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11308
MA
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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