Individual
AVERY TRIFONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16 GEDEON AVE, STURBRIDGE, MA 01566-1537
(774) 289-4821
Mailing address
16 GEDEON AVE, STURBRIDGE, MA 01566-1537
(774) 289-4821
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/26/2019
Last updated
09/26/2019
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