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NPI Code Detail

MEDICARE: KRISTIN OBRIEN

MEDICARE: KRISTIN OBRIEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1134507296
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN OBRIEN
Provider Business Mailing Address
First Line : 11 OLD DERRY RD
Second Line :
City : SALEM
State : NH
Zip : 03079-1244
Country : US
Telephone Number : 978-995-4700
Fax Number :
Provider Business Practice Location Address
First Line : 132 ROBBS HILL RD
Second Line :
City : LUNENBURG
State : MA
Zip : 01462-2167
Country : US
Telephone Number : 978-995-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2015
Last Update Date : 07/25/2019

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