MEDICARE: MR. PAUL ANDREW HOUGH SR. BCBA

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
1	103K00000X	Behavior Analyst	1-06-3171	MA

General Provider Information

NPI Number	:	1770887879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PAUL ANDREW HOUGH SR. BCBA

Provider Business Mailing Address
First Line	:	13 SUNSET DR
Second Line	:
City	:	MILFORD
State	:	MA
Zip	:	01757-1317
Country	:	US
Telephone Number	:	617-293-8457
Fax Number	:

Provider Business Practice Location Address
First Line	:	13 SUNSET DR
Second Line	:
City	:	MILFORD
State	:	MA
Zip	:	01757-1317
Country	:	US
Telephone Number	:	617-293-8457
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2011
Last Update Date	:	01/04/2011

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