Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003284415 |
---|---|
Provider Name | Matthew Speliotis |
First Address | Danvers, MA 01923-1409 |
Second Address | Danvers, MA 01923-1409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2015 |
Last Update Date | 02/09/2015 |