| Home Based Autism Therapy | |
|
158 Main St Spencer MA 01562-2260 | |
| (774) 330-9846 | |
| Not Available |
| Full Name | Home Based Autism Therapy |
|---|---|
| Speciality | Behavior Analyst |
| Location | 158 Main St, Spencer, Massachusetts |
| Authorized Official Name and Position | Keggah Ghishijoh (OFFICE MANAGER) |
| Authorized Official Contact | 7743309846 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Home Based Autism Therapy 158 Main St Spencer MA 01562-2260 Ph: (774) 330-9846 | Home Based Autism Therapy 158 Main St Spencer MA 01562-2260 Ph: (774) 330-9846 |
| NPI Number | 1851796213 |
|---|---|
| Provider Enumeration Date | 10/28/2014 |
| Last Update Date | 10/28/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851796213 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-10-7244 (Connecticut) | Primary |
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