Individual
ABBI WIRTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 ROCHE BROS WAY STE 6-381, NORTH EASTON, MA 02356-1030
(855) 832-6727
Mailing address
20 ROCHE BROTHERS WAY STE 6-381, NORTH EASTON, MA 02356-1030
(855) 832-6727
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2996
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
12/16/2016
Last updated
04/22/2024
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