Provider Demographics
NPI:1568232445
Name:CAILIN QUALLIOTINE LLC
Entity Type:Organization
Organization Name:CAILIN QUALLIOTINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAILIN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUALLIOTINE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:413-612-7019
Mailing Address - Street 1:7 FLORENCE RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-2638
Mailing Address - Country:US
Mailing Address - Phone:413-612-7019
Mailing Address - Fax:
Practice Address - Street 1:7 FLORENCE RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-2638
Practice Address - Country:US
Practice Address - Phone:413-612-7019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty