Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1380 | MA |
NPI | 1013362144 |
---|---|
Provider Name | Kathryn Trust |
First Address | Marlborough, MA 01752-5520 |
Second Address | Marlborough, MA 01752-5520 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2016 |
Last Update Date | 17/03/2018 |