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General NPI Number Information
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NPI Number | 1124437132
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Entity Type | Individual
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Provider Name | AMBER VAILLANCOURT M. ED. COMS
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Gender | Female
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Dates
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Enumeration Date | 08/05/2014
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 200 SPRINGS RD
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City | BEDFORD
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State | MA
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Zip | 01730-1114
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Country | US
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Telephone | 781-687-4308
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Fax |
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Provider Business Mailing Address
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Address Line | 200 SPRINGS RD
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City | BEDFORD
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State | MA
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Zip | 01730-1114
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Country | US
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Telephone | 781-687-4308
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255R0406X
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Taxonomy Name | Blind Rehabilitation Specialist/Technologist
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License Number | 6854
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License Number State | NH
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