Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003375809 |
---|---|
Provider Name | Heather Allyson Steen Lobdell |
First Address | Boston, MA 02115-6200 |
Second Address | Boston, MA 02115-6200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2019 |
Last Update Date | 19/03/2019 |