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NPI Code Detail

MEDICARE: RYAN JOACHIM

MEDICARE: RYAN JOACHIM
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
1103K00000XBehavior AnalystS80387028MA

General Provider Information

NPI Number : 1366999542
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN JOACHIM
Provider Business Mailing Address
First Line : 52 OAK ST
Second Line :
City : MIDDLEBORO
State : MA
Zip : 02346-2078
Country : US
Telephone Number : 508-994-0885
Fax Number :
Provider Business Practice Location Address
First Line : 52 OAK ST
Second Line :
City : MIDDLEBORO
State : MA
Zip : 02346-2078
Country : US
Telephone Number : 508-994-0885
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2016
Last Update Date : 09/06/2016

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Directions to “ RYAN JOACHIM ” Practice Location

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