Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1023634110 |
---|---|
Provider Name | Samantha Marie Marmaud |
First Address | Milford, MA 01757-1750 |
Second Address | Milford, MA 01757-1750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2020 |
Last Update Date | 24/06/2020 |