Individual
AFLAUDITE GONCALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
87 WINTHROP ST, BROCKTON, MA 02301-5223
(857) 230-8674
Mailing address
87 WINTHROP ST, BROCKTON, MA 02301-5223
(857) 230-8674
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100024319831
—
MA
Enumeration date
05/13/2019
Last updated
05/13/2019
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