Organization
THE VILLAGE-CHILD & FAMILY DEVELOPMENT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CASSANDRA A CLARK MS, OTR/L (OWNER)
(781) 269-2323
Entity
Organization
Contact information
Practice address
25 ADAMS ST, 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
Primary
11745
MA
225XP0200X
Pediatric Occupational Therapist
19782
MA
225XP0200X
Pediatric Occupational Therapist
6919
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110093137A
—
MA
Enumeration date
10/15/2012
Last updated
10/15/2012
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