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General NPI Number Information
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NPI Number | 1063920056
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Entity Type | Individual
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Provider Name | JORDAN COHEN
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Gender | Male
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Dates
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Enumeration Date | 01/12/2018
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 321 FORTUNE BLVD
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City | MILFORD
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State | MA
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Zip | 01757-1750
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Country | US
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Telephone | 508-478-0207
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Fax | 508-634-6984
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Provider Business Mailing Address
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Address Line | 13 ACORN ST
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City | EAST LONGMEADOW
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State | MA
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Zip | 01028-1701
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Country | US
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Telephone | 508-397-4955
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-23-66926
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License Number State | MA
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