| NPI | 1720515711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON HERSCOVITCH Program Director/Owner 617-505-6183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2017-05-22 |