Most Relevant Information
Provider Data
| NPI Number: | 1003551482 |
| Provider Name: | SAMANTHA MARVEL MCGOURTY |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/01/2022 |
| Last Updated: | 05/01/2022 |
Provider Practice Location
225 CEDAR HILL ST STE 200
MARLBOROUGH
MA
017525900
Practice Location Phone/Fax
| Phone: | 8888809270 |
| Fax: |
Provider Mailing Location
151 BARNA ST
LUDLOW
MA
010561204
Provider Mailing Phone/Fax
| Phone: | 4134268868 |
| Fax: |