Individual
DANIELLE STOTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3620 MYSTIC VALLEY PKWY APT E902, MEDFORD, MA 02155-5776
(253) 579-4913
Mailing address
3620 MYSTIC VALLEY PKWY APT E902, MEDFORD, MA 02155-5776
(253) 579-4913
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MA
Other
Enumeration date
02/23/2022
Last updated
02/23/2022
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