Individual
DEJANARA POR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8 FANEUIL HALL MARKETPLACE FL 3, BOSTON, MA 02109-6114
(617) 863-9090
Mailing address
25 TERSOLO RD, HAVERHILL, MA 01832-8629
(978) 476-1980
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/11/2021
Last updated
10/11/2021
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