Provider Demographics
NPI:1730405416
Name:PLONE, SALLY JANE
Entity type:Individual
Prefix:MS
First Name:SALLY
Middle Name:JANE
Last Name:PLONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:49 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02466-1709
Mailing Address - Country:US
Mailing Address - Phone:617-593-7344
Mailing Address - Fax:866-826-3011
Practice Address - Street 1:72 LANGLEY RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-1909
Practice Address - Country:US
Practice Address - Phone:617-593-7344
Practice Address - Fax:866-826-3011
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMH3346-CC101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional