Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003409889 |
---|---|
Provider Name | Sara Raposo |
First Address | New Bedford, MA 02740-2120 |
Second Address | Rochester, MA 02770-4024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2021 |
Last Update Date | 12/02/2021 |