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NPI Code Detail

MEDICARE: LISA WEATHERFORD

MEDICARE: LISA WEATHERFORD
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

General Provider Information

NPI Number : 1639582315
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA WEATHERFORD
Provider Business Mailing Address
First Line : 33 PERRY AVE
Second Line :
City : ATTLEBORO
State : MA
Zip : 02703-2417
Country : US
Telephone Number : 508-954-3054
Fax Number :
Provider Business Practice Location Address
First Line : 33 PERRY AVE
Second Line :
City : ATTLEBORO
State : MA
Zip : 02703-2417
Country : US
Telephone Number : 508-954-3054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2014
Last Update Date : 06/10/2014

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Directions to “ LISA WEATHERFORD ” Practice Location

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