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NPI Code Detail

MEDICARE: MISS PENNI DYAN MINDES EDUCATOR

MEDICARE: MISS PENNI DYAN MINDES EDUCATOR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist
2222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1558552398
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS PENNI DYAN MINDES EDUCATOR
Provider Business Mailing Address
First Line : 300 E MAIN ST
Second Line :
City : MILFORD
State : MA
Zip : 01757-2806
Country : US
Telephone Number : 508-478-0207
Fax Number : 508-634-6984
Provider Business Practice Location Address
First Line : 300 E MAIN ST
Second Line :
City : MILFORD
State : MA
Zip : 01757-2806
Country : US
Telephone Number : 508-478-0207
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2007
Last Update Date : 06/29/2024

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Directions to “ MISS PENNI DYAN MINDES EDUCATOR” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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