Provider Demographics
NPI:1437502259
Name:CANESI, JUDY
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:CANESI
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 1:251 FLETCHER LN
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631-3034
Mailing Address - Country:US
Mailing Address - Phone:508-737-0003
Mailing Address - Fax:
Practice Address - Street 1:251 FLETCHER LN
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:MA
Practice Address - Zip Code:02631-3034
Practice Address - Country:US
Practice Address - Phone:508-737-0003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-16
Last Update Date:2016-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst