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General NPI Number Information
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NPI Number | 1720680457
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Entity Type | Organization
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Legal Business Name | FOUR OUT OF FOUR PROGRAMS & SERVICES LLC
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Dates
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Enumeration Date | 11/09/2020
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 17 GUNN RD EXT UNIT C
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City | SOUTHAMPTON
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State | MA
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Zip | 01073-9648
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Country | US
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Telephone | 413-217-4667
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Fax | 413-341-8046
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Provider Business Mailing Address
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Address Line | 17 GUNN RD EXT UNIT C
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City | SOUTHAMPTON
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State | MA
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Zip | 01073-9648
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Country | US
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Telephone | 413-217-4667
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Fax | 413-341-8046
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Authorized Official
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Title or Position | OWNER
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Name | JULIA NEDRY
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Credential |
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Telephone | 413-217-4667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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