Provider Demographics
NPI:1548009194
Name:CAGLE, CAMERON THOMAS
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:THOMAS
Last Name:CAGLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-3433
Mailing Address - Country:US
Mailing Address - Phone:719-271-0213
Mailing Address - Fax:
Practice Address - Street 1:379 LOWELL ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-3433
Practice Address - Country:US
Practice Address - Phone:719-271-0213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician