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General NPI Number Information
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NPI Number | 1629401286
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Entity Type | Individual
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Provider Name | MICHELLE SANTANGELO BCBA
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Gender | Female
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Dates
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Enumeration Date | 08/18/2013
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Last Update Date | 08/07/2015
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Provider Practice Location Address
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Address Line | 130 AUSTINE DR
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City | BRATTLEBORO
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State | VT
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Zip | 05301-7040
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Country | US
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Telephone | 802-451-0189
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3438
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City | AMHERST
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State | MA
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Zip | 01004-3438
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Country | US
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Telephone | 413-297-1379
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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 |
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License Number State |
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