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Individual

BINTA BOBO BA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
17 RIVERS EDGE PL, METHUEN, MA 01844-6340
(617) 407-0986
Mailing address
17 RIVERS EDGE PL, METHUEN, MA 01844-6340
(617) 407-0986

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
542528020
PASSPORT
MA
Enumeration date
02/25/2021
Last updated
02/25/2021
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