Organization
SPORT STATION ADAPTED EXERCISES CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILA GONCALVES DE ASSIS (OWNER)
(508) 663-6580
Entity
Organization
Contact information
Practice address
696 WASHINGTON ST APT 1, HOLLISTON, MA 01746-2186
(508) 663-6580
Mailing address
696 WASHINGTON ST APT 1, HOLLISTON, MA 01746-2186
(508) 663-6580
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/29/2025
Last updated
09/11/2025
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