Individual
ROSE MARIE SHANNON FRASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SOME COLLEGE
Contact information
Practice address
100 CUMMINGS CTR STE 320A&B, BEVERLY, MA 01915-6115
(978) 867-0431
Mailing address
21600 OXNARD ST, WOODLAND HILLS, CA 91367-4976
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
16780193
MA
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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