Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003350018 |
---|---|
Provider Name | Marina Kristine Apostolou |
First Address | Lowell, MA 01851-2705 |
Second Address | Lowell, MA 01851-2705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2016 |
Last Update Date | 09/12/2016 |