Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013301886 |
---|---|
Provider Name | Catherine Mcdonough |
First Address | Marstons Mills, MA 02648-1350 |
Second Address | Marstons Mills, MA 02648-1350 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2015 |
Last Update Date | 19/03/2015 |