Individual
NICOLE COLUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
18 COTTAGE ST, MEDFIELD, MA 02052-1616
(508) 668-4695
(617) 958-9217
Mailing address
18 COTTAGE ST, MEDFIELD, MA 02052-1616
(508) 688-4695
(617) 928-9217
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2824
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2824
STATE OF MASSACHUSSETTS LICENSED ABA PROVIDER
MA
Enumeration date
10/31/2019
Last updated
10/31/2019
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