Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106E00000X | Assistant Behavior Analyst | ||
Y | 106S00000X | Behavior Technician |
NPI | 1144807397 |
---|---|
Provider Name | Laurel Mazzarelli |
First Address | Chatham, MA 02633-2305 |
Second Address | East Sandwich, MA 02537-1438 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2021 |
Last Update Date | 25/03/2021 |