Provider Demographics
NPI:1235488016
Name:MASSON, NATALIE NICOLE (DPT)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:NICOLE
Last Name:MASSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 ROBINSON ST.
Mailing Address - Street 2:EASTER SEALS RI
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-3590
Mailing Address - Country:US
Mailing Address - Phone:401-284-1000
Mailing Address - Fax:401-284-1006
Practice Address - Street 1:213 ROBINSON ST.
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-3590
Practice Address - Country:US
Practice Address - Phone:401-284-1000
Practice Address - Fax:401-284-1006
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT02500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist