Healthcare Provider Details

I. General information

NPI: 1316699960
Provider Name (Legal Business Name): CHRISTINE OHRENBERGER BCBA, LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 01/31/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 ACCORD PARK DR
NORWELL MA
02061-1606
US

IV. Provider business mailing address

104 CANONCHET TRL
MARSHFIELD MA
02050-8227
US

V. Phone/Fax

Practice location:
  • Phone: 781-923-0900
  • Fax:
Mailing address:
  • Phone: 781-724-7952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number3825
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: