Provider Demographics
NPI:1497585095
Name:ACT NEURODEVELOPMENTAL SERVICES, PLLC
Entity type:Organization
Organization Name:ACT NEURODEVELOPMENTAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAYA-HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-654-8112
Mailing Address - Street 1:47 MANSFIELD ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-3101
Mailing Address - Country:US
Mailing Address - Phone:781-654-8112
Mailing Address - Fax:781-654-8121
Practice Address - Street 1:745 HIGH ST STE 205
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-2531
Practice Address - Country:US
Practice Address - Phone:781-654-8112
Practice Address - Fax:781-654-8121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty