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General NPI Number Information
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NPI Number | 1497942718
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Entity Type | Individual
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Provider Name | MRS. JUDITH L. T. HARVESTER
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Gender | Female
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 175 N BEACON STREET
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City | WATERTOWN
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State | MA
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Zip | 02472
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Country | US
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Telephone | 617-972-7444
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1108
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City | WESTFIELD
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State | MA
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Zip | 01086-1108
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Country | US
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Telephone | 413-454-1829
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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