Healthcare Provider Details

I. General information

NPI: 1275174575
Provider Name (Legal Business Name): DEVON ROSE PRITCHETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2019
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E MAIN ST STE 200
MILFORD MA
01757-2806
US

IV. Provider business mailing address

300 E MAIN ST STE 200
MILFORD MA
01757-2806
US

V. Phone/Fax

Practice location:
  • Phone: 508-478-0207
  • Fax: 508-634-6984
Mailing address:
  • Phone: 508-478-0207
  • Fax: 508-634-6984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLABA10000089
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: