Organization
BAMSI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENEVIEVE MUDD OTR/L (OCCUPATIONAL THERAPIST)
(508) 586-5977
Entity
Organization
Contact information
Practice address
801 PLEASANT ST, BROCKTON, MA 02301-3052
(508) 586-5977
Mailing address
801 PLEASANT ST, BROCKTON, MA 02301-3052
(508) 586-5977
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
11862
MA
Other
Enumeration date
05/03/2016
Last updated
05/03/2016
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