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NPI Code Detail

MEDICARE: ALLISON BLOOM CULKIN

MEDICARE: ALLISON BLOOM CULKIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1013522143
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON BLOOM CULKIN
Provider Business Mailing Address
First Line : 61 SACHEM ST
Second Line :
City : QUINCY
State : MA
Zip : 02170-2447
Country : US
Telephone Number : 781-426-6395
Fax Number :
Provider Business Practice Location Address
First Line : 800 TECHNOLOGY CENTER DR STE 110
Second Line :
City : STOUGHTON
State : MA
Zip : 02072-4721
Country : US
Telephone Number : 781-290-3886
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2020
Last Update Date : 01/10/2022

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Directions to “ ALLISON BLOOM CULKIN ” Practice Location

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