| NPI | 1134541931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELDON WAGNER Psychologist 508-990-1620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 1-04-2018) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA 1-12-10449) |
| 103T00000X Psychologist (Licence: MA 4917) | |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2014-01-13 |