Individual
MS. LAURIE ANNE HOULE ISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LABA
Contact information
Practice address
110 MAPLE ST FL 3, SPRINGFIELD, MA 01105-1864
(413) 750-8112
(413) 737-3000
Mailing address
110 MAPLE ST FL 3, SPRINGFIELD, MA 01105-1864
(413) 750-8112
(413) 737-3000
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11417449
MA
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
06/04/2018
Last updated
06/04/2018
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