Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003286899 |
---|---|
Provider Name | Angellica Reyes |
First Address | Fall River, MA 02720-1700 |
Second Address | Pocasset, MA 02559-1980 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2015 |
Last Update Date | 06/10/2015 |