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NPI Code Detail

MEDICARE: YVETTE ROSE STODDARD BCBA, LABA, LBA

MEDICARE:   YVETTE ROSE STODDARD  BCBA, LABA, LBA
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 Analyst353MA
2103K00000XBehavior Analyst004361NY

General Provider Information

NPI Number : 1588152219
Entity Type Code : Individual
Provider Name (Legal Business Name) : YVETTE ROSE STODDARD BCBA, LABA, LBA
Provider Business Mailing Address
First Line : 576 NORTH ST
Second Line :
City : WINDSOR
State : MA
Zip : 01270-9257
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 576 NORTH ST
Second Line :
City : WINDSOR
State : MA
Zip : 01270-9257
Country : US
Telephone Number : 516-475-2088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2018
Last Update Date : 04/06/2026

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Directions to “ YVETTE ROSE STODDARD BCBA, LABA, LBA” Practice Location

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