Individual
DEREK JOHN BIRCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
373 S WILLOW ST STE 266, MANCHESTER, NH 03103-5751
(877) 315-8080
(877) 345-4009
Mailing address
122 RICHARDS AVE, PORTSMOUTH, NH 03801-5236
(603) 208-9359
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
05/14/2014
Last updated
10/04/2019
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