Individual
DR. GORDON ANTHONY DEFALCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA-D,PHD,LABA
Contact information
Practice address
16 BRIDGE GATE, PLYMOUTH, MA 02360-6377
(508) 287-8692
(508) 591-7886
Mailing address
16 BRIDGE GATE, PLYMOUTH, MA 02360-6377
(508) 287-8692
(508) 591-7886
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-04-1493
MA
103K00000X
Behavior Analyst
Primary
882
MA
103TB0200X
Cognitive & Behavioral Psychologist
1-04-1493
—
Other
Enumeration date
11/04/2006
Last updated
09/03/2016
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