Individual
NICOLE CAITLIN COWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
639 GRANITE ST STE 302, BRAINTREE, MA 02184-5370
(877) 793-2740
Mailing address
590 DEDHAM ST, WRENTHAM, MA 02093-1142
(508) 309-9098
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-48718
MA
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
12/07/2017
Last updated
05/21/2024
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