Healthcare Provider Details

I. General information

NPI: 1710267786
Provider Name (Legal Business Name): RENEE PLOUFFE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2011
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 PLEASANT ST
NORTON MA
02766-2070
US

IV. Provider business mailing address

41 PLEASANT ST
NORTON MA
02766-2070
US

V. Phone/Fax

Practice location:
  • Phone: 508-455-6200
  • Fax: 508-222-0530
Mailing address:
  • Phone: 508-455-6200
  • Fax: 508-222-0530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number10001144
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: