Individual
SAMANTHA TARDIF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LABA
Contact information
Practice address
9 COLE ST, BEVERLY, MA 01915-1953
(207) 689-7621
Mailing address
9 COLE ST, BEVERLY, MA 01915-1953
(207) 689-7621
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11519047
MA
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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