Organization
THE VILLAGE-CHILD & FAMILY DEVELOPMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CASSANDRA ADELIA CLARK MS, OTR/L (OCCUPATIONAL THERAPIST/OWNER)
(781) 269-2323
Entity
Organization
Contact information
Practice address
25 ADAMS ST, SUITE 104, BRAINTREE, MA 02184-1911
(781) 269-2323
Mailing address
28 SHADE ST, RANDOLPH, MA 02368-1769
(781) 269-2323
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
11745
MA
225XP0200X
Pediatric Occupational Therapist
Primary
6919
MA
225XP0200X
Pediatric Occupational Therapist
9522
MA
235Z00000X
Speech-Language Pathologist
6606
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110093137A
—
MA
Enumeration date
09/12/2011
Last updated
10/02/2012
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