Individual
LOIS FORNAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 BURLINGTON RD, BEDFORD, MA 01730-1406
(781) 761-5089
Mailing address
205 BURLINGTON RD, BEDFORD, MA 01730-1406
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133002417
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000023532
BMC
MA
01
—
042611055
TAX ID
MA
01
—
1004745
NHP
MA
01
—
1303287
MBHP
MA
01
—
99618201
NETWORK HEALTH
MA
01
—
M18633
BCBS
MA
Enumeration date
04/28/2020
Last updated
11/16/2022
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