Provider Demographics
NPI:1033708193
Name:MASUCCI, ABIGAIL LEIGH
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LEIGH
Last Name:MASUCCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 E GROVE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1816
Mailing Address - Country:US
Mailing Address - Phone:781-966-5770
Mailing Address - Fax:
Practice Address - Street 1:42 WASHINGTON ST STE 110
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-1817
Practice Address - Country:US
Practice Address - Phone:781-966-5770
Practice Address - Fax:774-213-5479
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst