Provider Demographics
NPI:1437929262
Name:CHAMBERLAND, CASSIDI ELAINE
Entity Type:Individual
Prefix:
First Name:CASSIDI
Middle Name:ELAINE
Last Name:CHAMBERLAND
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 1:195 PASCOAG MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PASCOAG
Mailing Address - State:RI
Mailing Address - Zip Code:02859-3105
Mailing Address - Country:US
Mailing Address - Phone:401-680-2339
Mailing Address - Fax:
Practice Address - Street 1:300 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2806
Practice Address - Country:US
Practice Address - Phone:508-478-0207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist