Healthcare Provider Details

I. General information

NPI: 1710815337
Provider Name (Legal Business Name): CASSANDRA E COVENEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 MAPLE ST
CLINTON MA
01510-1903
US

IV. Provider business mailing address

53 MAPLE ST
CLINTON MA
01510-1903
US

V. Phone/Fax

Practice location:
  • Phone: 781-974-3736
  • Fax:
Mailing address:
  • Phone: 781-974-3736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number00021612
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: