Provider Demographics
NPI:1366796328
Name:THE INSTITUTE OF PROFESSIONAL PRACTICES, INC.
Entity type:Organization
Organization Name:THE INSTITUTE OF PROFESSIONAL PRACTICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CLINICAL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:978-353-3480
Mailing Address - Street 1:270 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-8114
Mailing Address - Country:US
Mailing Address - Phone:978-353-3480
Mailing Address - Fax:
Practice Address - Street 1:270 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-8114
Practice Address - Country:US
Practice Address - Phone:978-353-3480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty