Provider Demographics
NPI:1417308008
Name:BOSTON SENSORY SOLUTIONS
Entity Type:Organization
Organization Name:BOSTON SENSORY SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OT
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:
Authorized Official - Last Name:DUJARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:617-691-7140
Mailing Address - Street 1:54 KENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-2228
Mailing Address - Country:US
Mailing Address - Phone:617-872-2276
Mailing Address - Fax:617-507-0457
Practice Address - Street 1:500 GRANITE AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-5626
Practice Address - Country:US
Practice Address - Phone:617-872-2276
Practice Address - Fax:617-507-0457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-25
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6911225X00000X
261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1376842369OtherSPEECH LANGUAGE PATHOLOGIST