Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003441304 |
---|---|
Provider Name | Mr. John Anthony Mcmahon III |
First Address | Seekonk, MA 02771-3740 |
Second Address | Seekonk, MA 02771-3740 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2020 |
Last Update Date | 06/03/2020 |