Basic Information
| Provider Information | |||||||||
| NPI: | 1851594204 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KASS | ||||||||
| FirstName: | DEBRA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | COTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22 LARCH LN | ||||||||
| Address2: | |||||||||
| City: | READING | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018671458 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 500 CUMMINGS CTR | ||||||||
| Address2: | SUITE 3850, PROJECT CHILLD | ||||||||
| City: | BEVERLY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019156142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9782320332 | ||||||||
| FaxNumber: | 9782321103 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2007 | ||||||||
| LastUpdateDate: | 07/07/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 2532 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.