| Sport Development Services Inc. | |
|
19 Boyden St Boston MA 02124-3212 | |
| (781) 244-0894 | |
| Not Available |
| Full Name | Sport Development Services Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 19 Boyden St, Boston, Massachusetts |
| Authorized Official Name and Position | Floyd Ashton Williams-agnew (FOUNDER/EXECUTIVE DIRECTOR/MENTOR) |
| Authorized Official Contact | 7812440894 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sport Development Services Inc. 19 Boyden St Boston MA 02124-3212 Ph: () - | Sport Development Services Inc. 19 Boyden St Boston MA 02124-3212 Ph: (781) 244-0894 |
| NPI Number | 1396407284 |
|---|---|
| Provider Enumeration Date | 10/08/2021 |
| Last Update Date | 10/08/2021 |
| Certification Date | 10/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396407284 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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