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General NPI Number Information
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NPI Number | 1750291530
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Entity Type | Individual
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Provider Name | LISA PEZZELLA
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Gender | Female
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Dates
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Enumeration Date | 09/11/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 18 COMMERCE WAY STE 1500
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City | WOBURN
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State | MA
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Zip | 01801-1077
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Country | US
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Telephone | 781-460-9756
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Fax | 260-547-7935
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Provider Business Mailing Address
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Address Line | 18 COMMERCE WAY STE 1500
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City | WOBURN
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State | MA
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Zip | 01801-1077
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Country | US
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Telephone | 781-460-9756
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Fax | 260-548-7935
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 1054242
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License Number State | MA
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