Healthcare Provider Details

I. General information

NPI: 1174847602
Provider Name (Legal Business Name): DORIA BERMAN BCBA LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2010
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 CENTRE ST
BROCKTON MA
02302-3307
US

IV. Provider business mailing address

52 OLD MANSION LN
WHITMAN MA
02382-1026
US

V. Phone/Fax

Practice location:
  • Phone: 508-478-0207
  • Fax: 508-634-6984
Mailing address:
  • Phone: 339-788-1175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: