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General NPI Number Information
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NPI Number | 1700187044
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Entity Type | Individual
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Provider Name | ERICA MARIE ANDRESEN BCBA
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Gender | Female
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Dates
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Enumeration Date | 11/03/2010
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Last Update Date | 03/12/2013
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Provider Practice Location Address
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Address Line | 47 HIGH ST
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City | SHARON
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State | MA
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Zip | 02067-1419
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Country | US
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Telephone | 650-380-4260
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Fax |
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Provider Business Mailing Address
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Address Line | 47 HIGH ST
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City | SHARON
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State | MA
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Zip | 02067-1419
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Country | US
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Telephone | 650-380-4260
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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 | 1-03-1061
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License Number State | MA
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