Individual
MRS. WANDA MERAB DE FREITAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
321 FORTUNE BLVD, MILFORD, MA 01757-1750
(508) 478-0207
(508) 634-6984
Mailing address
321 FORTUNE BLVD, MILFORD, MA 01757-1750
(508) 478-0207
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6175417
DRIVERS LICENSE
PR
Enumeration date
10/10/2019
Last updated
05/02/2024
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