Individual
CARLOS PERDOMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
43 PROSPECT ST, BRISTOL, RI 02809-3156
(570) 793-6219
Mailing address
43 PROSPECT ST, BRISTOL, RI 02809-3156
(570) 793-6219
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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