Provider Demographics
NPI:1750012860
Name:BRAID, SHAUNNA
Entity Type:Individual
Prefix:
First Name:SHAUNNA
Middle Name:
Last Name:BRAID
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 1:585 E RIVER ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:MA
Mailing Address - Zip Code:01364-1811
Mailing Address - Country:US
Mailing Address - Phone:978-575-4175
Mailing Address - Fax:978-849-5192
Practice Address - Street 1:585 E RIVER ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:MA
Practice Address - Zip Code:01364-1811
Practice Address - Country:US
Practice Address - Phone:978-575-4175
Practice Address - Fax:978-849-5192
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator