Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1013564202 |
---|---|
Provider Name | Geri Sue Leporati |
First Address | Springfield, MA 01104-3736 |
Second Address | Springfield, MA 01104-3736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2019 |
Last Update Date | 22/08/2019 |