Individual
BETHANY MARIE DELACT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 MORELAND ST, ROXBURY, MA 02119-2382
(857) 930-9457
Mailing address
25 MORELAND ST, ROXBURY, MA 02119-2382
(857) 930-9457
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
3615455
RI
Other
Enumeration date
01/24/2019
Last updated
01/24/2019
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