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1174960520
MICHENIDE AUGUSTIN
BROCKTON, MA
NPI
1174960520
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
252Y00000X Early Intervention Provider Agency
Enumeration Date
2013-05-24
Last Update Date
2013-05-24
Business Address
-- MICHENIDE AUGUSTIN
1115 W CHESTNUT ST
BROCKTON, MA 02301-7501
Phone number: 508-580-4691
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Mailing Address
-- MICHENIDE AUGUSTIN
215 COURT ST APT 1
BROCKTON, MA 02302-4600
Phone number: 617-682-5550
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