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Individual

MISS SAMANTHA TAYLOR O'MALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
375 WESGATE DR, BROCKTON, MA 02301
(774) 360-6232
Mailing address
1 SCHOOL ST APT 9, SOUTH EASTON, MA 02375-1556
(774) 360-6232

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
MA
106S00000X
Behavior Technician
MA
390200000X
Student in an Organized Health Care Education/Training Program
DONTHAVEONE
MA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
08/13/2020
Last updated
11/07/2022
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