Individual
BOA MOUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44 HIGHLAND AVE APT 1, FITCHBURG, MA 01420-7815
(978) 870-5502
Mailing address
44 HIGHLAND AVE APT 1, FITCHBURG, MA 01420-7815
(978) 870-5502
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/25/2018
Last updated
05/25/2018
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