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General NPI Number Information
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NPI Number | 1740105949
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Entity Type | Individual
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Provider Name | JYNELL ANNA STRUSS
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Gender | Female
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 23 CROSBY DR
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City | BEDFORD
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State | MA
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Zip | 01730-1423
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Country | US
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Telephone | 718-832-3146
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Fax |
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Provider Business Mailing Address
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Address Line | 192 SCHOOL ST
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City | SOMERVILLE
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State | MA
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Zip | 02145-3816
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Country | US
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Telephone |
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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 | LABANE10002450
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License Number State | MA
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