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General NPI Number Information
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NPI Number | 1124992656
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Entity Type | Organization
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Legal Business Name | BROWN DOG THERAPY AND WELLNESS, LLC
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 1179 MAIN ST STE 1
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City | WAKEFIELD
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State | MA
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Zip | 01880-9991
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Country | US
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Telephone | 571-749-5958
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3072 1179 MAIN ST STE 1
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City | WAKEFIELD
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State | MA
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Zip | 01880-9991
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Country | US
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Telephone | 571-749-5958
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALLISON GASCA-BACKMAN
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Credential | LICSW
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Telephone | 978-835-2623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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