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General NPI Number Information
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NPI Number | 1710484373
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Entity Type | Individual
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Provider Name | MICKAYLA ELIZABETH COBB
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Gender | Female
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 10 FORBES RD STE 250E
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City | BRAINTREE
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State | MA
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Zip | 02184-2605
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Country | US
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Telephone | 781-630-4663
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Fax | 781-356-9042
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Provider Business Mailing Address
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Address Line | 10 FORBES RD STE 250E
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City | BRAINTREE
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State | MA
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Zip | 02184-2605
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Country | US
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Telephone | 781-630-4663
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Fax | 781-356-9042
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | LCSW228586
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License Number State | MA
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