Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013214188 |
---|---|
Provider Name | Colleen F Cull |
First Address | Boston, MA 02128-2708 |
Second Address | Boston, MA 02128-2708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2011 |
Last Update Date | 24/02/2011 |