Provider Demographics
NPI:1932697778
Name:PRATT, MARIA ZOFIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ZOFIA
Last Name:PRATT
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 1:33 BROOK ST APT 7
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-5170
Mailing Address - Country:US
Mailing Address - Phone:508-371-0075
Mailing Address - Fax:
Practice Address - Street 1:33 BROOK ST APT 7
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-5170
Practice Address - Country:US
Practice Address - Phone:508-371-0075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician