| Wave Break Therapy, Pllc | |
|
82 Wendell Ave Ste 100 Pittsfield MA 01201-7066 | |
| (617) 564-0153 | |
| Not Available |
| Full Name | Wave Break Therapy, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 82 Wendell Ave Ste 100, Pittsfield, Massachusetts |
| Authorized Official Name and Position | Lauren C Omenazu (CO-OWNER) |
| Authorized Official Contact | 6175640153 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wave Break Therapy, Pllc 82 Wendell Ave Ste 100 Pittsfield MA 01201-7066 Ph: (617) 564-0153 | Wave Break Therapy, Pllc 82 Wendell Ave Ste 100 Pittsfield MA 01201-7066 Ph: (617) 564-0153 |
| NPI Number | 1528813599 |
|---|---|
| Provider Enumeration Date | 04/22/2024 |
| Last Update Date | 04/22/2024 |
| Certification Date | 04/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528813599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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