Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003316597 |
---|---|
Provider Name | Samantha Solari |
First Address | East Bridgewater, MA 02333-1507 |
Second Address | Stoughton, MA 02072-1163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2018 |
Last Update Date | 17/03/2018 |