| Intentional Self. Llc | |
|
6 Cabot Pl Suite # 6 Stoughton MA 02072-4625 | |
| (781) 767-0008 | |
| Not Available |
| Full Name | Intentional Self. Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6 Cabot Pl, Stoughton, Massachusetts |
| Authorized Official Name and Position | Sandra C Range (OWNER) |
| Authorized Official Contact | 7817670008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intentional Self. Llc 141 Memorial Pkwy Pmb 211 Randolph MA 02368-4511 Ph: (781) 767-0008 | Intentional Self. Llc 6 Cabot Pl Suite # 6 Stoughton MA 02072-4625 Ph: (781) 767-0008 |
| NPI Number | 1972924371 |
|---|---|
| Provider Enumeration Date | 01/02/2014 |
| Last Update Date | 01/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972924371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5509 (Massachusetts) | Primary |
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