Individual
TIANA MARIA DENISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
67 S BEDFORD ST STE 101W, BURLINGTON, MA 01803-5152
(617) 865-9445
Mailing address
67 S BEDFORD ST STE 101W, BURLINGTON, MA 01803-5152
(617) 865-9445
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-37355
—
106E00000X
Assistant Behavior Analyst
—
—
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
01/17/2017
Last updated
07/31/2024
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