Individual
CORTNEIGH ALYSSA BLIZARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
33 PERRY AVE, ATTLEBORO, MA 02703-2417
(508) 455-6200
Mailing address
33 PERRY AVE, ATTLEBORO, MA 02703-2417
(508) 455-6200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083946172
COMMERCIAL
MA
Enumeration date
08/30/2019
Last updated
08/30/2019
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