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General NPI Number Information
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NPI Number | 1104274158
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Entity Type | Individual
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Provider Name | JASON RUBINO BCBA, LABA (MA)
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Gender | Male
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Dates
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Enumeration Date | 06/01/2016
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 254 N BROADWAY UNIT 112
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City | SALEM
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State | NH
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Zip | 03079-2132
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Country | US
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Telephone | 561-917-7205
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Fax |
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Provider Business Mailing Address
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Address Line | 542 AMHERST ST STE B
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City | NASHUA
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State | NH
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Zip | 03063-1016
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Country | US
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Telephone | 561-917-7205
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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 | 475
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-11-8336
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License Number State |
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