Individual
THOMAS K WEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
99 S MAIN ST, FALL RIVER, MA 02721-5375
(800) 679-3609
Mailing address
41 PACELLA PARK DR, RANDOLPH, MA 02368-1755
(781) 440-0400
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LABA10000048
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
05/20/2019
Last updated
03/24/2023
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