Healthcare Provider Details

I. General information

NPI: 1851216634
Provider Name (Legal Business Name): ASHLEY IRENE POUSSARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

543 NORTH ST STE E
NEW BEDFORD MA
02740-2782
US

IV. Provider business mailing address

35 SUNNYSIDE PARK
SAUGUS MA
01906-3062
US

V. Phone/Fax

Practice location:
  • Phone: 508-742-6419
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: