Healthcare Provider Details

I. General information

NPI: 1235624180
Provider Name (Legal Business Name): PUTTING THE PIECES TOGETHER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2018
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 HAGER PARK RD
WESTMINSTER MA
01473-1523
US

IV. Provider business mailing address

27 HAGER PARK RD
WESTMINSTER MA
01473-1523
US

V. Phone/Fax

Practice location:
  • Phone: 978-870-3927
  • Fax:
Mailing address:
  • Phone: 978-870-3927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1543
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: KRYSTINA MARIE COLLAZO
Title or Position: OWNER
Credential: BCBA
Phone: 978-870-3927