Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1124542600 |
---|---|
Provider Name | Maria Centeio |
First Address | Hyde Park, MA 02136-1646 |
Second Address | Hyde Park, MA 02136-1646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2017 |
Last Update Date | 27/07/2017 |