Healthcare Provider Details

I. General information

NPI: 1003521329
Provider Name (Legal Business Name): KASSIE FRANCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2023
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 WASHINGTON ST
NORWOOD MA
02062-2212
US

IV. Provider business mailing address

92 GORDON ST APT 402
BOSTON MA
02135-6219
US

V. Phone/Fax

Practice location:
  • Phone: 508-233-2293
  • Fax:
Mailing address:
  • Phone: 843-489-5729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number14728
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: