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General NPI Number Information
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NPI Number | 1437492790
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Entity Type | Organization
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Legal Business Name | MAYFLOWER BEHAVIOR ANALYSIS LLC
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Dates
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Enumeration Date | 04/04/2013
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Last Update Date | 04/04/2013
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Provider Practice Location Address
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Address Line | 36 DIGHTON ST APT 5
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City | BRIGHTON
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State | MA
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Zip | 02135-3227
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Country | US
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Telephone | 818-859-3742
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Fax |
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Provider Business Mailing Address
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Address Line | 36 DIGHTON ST APT 5
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City | BRIGHTON
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State | MA
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Zip | 02135-3227
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Country | US
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Telephone | 818-859-3742
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Fax |
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Authorized Official
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Title or Position | SENIOR BEHAVIOR ANALYST
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Name | LAUREN PALMER
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Credential | M.S., BCBA
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Telephone | 818-859-3742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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