Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003376641 |
---|---|
Provider Name | Yaraima Mercado |
First Address | Boston, MA 02115-3629 |
Second Address | Lunenburg, MA 01462-2167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2019 |
Last Update Date | 25/07/2019 |