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General NPI Number Information
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NPI Number | 1356718613
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Entity Type | Organization
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Legal Business Name | POSITIVE BEHAVIORAL SOLUTIONS, LLC
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Dates
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Enumeration Date | 08/21/2015
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Last Update Date | 08/21/2015
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Provider Practice Location Address
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Address Line | 69 MAIN ST
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City | FAIRHAVEN
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State | MA
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Zip | 02719-2923
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Country | US
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Telephone | 508-997-1311
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Fax | 508-997-1312
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Provider Business Mailing Address
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Address Line | 9 DOUGLAS COR
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City | ROCHESTER
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State | MA
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Zip | 02770-1010
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Country | US
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Telephone | 774-205-0227
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Fax | 508-997-1312
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. SINEAD PETERSEN
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Credential | PHD, BCBA-D, LMHC
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Telephone | 774-205-0227
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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 |
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License Number State |
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