Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003343088 |
---|---|
Provider Name | Erin Clifford |
First Address | Woburn, MA 01801-1721 |
Second Address | Woburn, MA 01801-1721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2017 |
Last Update Date | 22/05/2017 |