Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 1917 | MA |
NPI | 1093229494 |
---|---|
Provider Name | Michelle Mitropoulos |
First Address | Arlington, MA 02474-3203 |
Second Address | Marlborough, MA 01752-5900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2017 |
Last Update Date | 21/11/2017 |