Provider Demographics
NPI:1710267786
Name:PLOUFFE, RENEE
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:PLOUFFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-2070
Mailing Address - Country:US
Mailing Address - Phone:508-455-6200
Mailing Address - Fax:508-222-0530
Practice Address - Street 1:41 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-2070
Practice Address - Country:US
Practice Address - Phone:508-455-6200
Practice Address - Fax:508-222-0530
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10001144103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110026265Medicaid