Individual
CARLY BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
80 WASHINGTON ST BLDG P, NORWELL, MA 02061-1740
(781) 290-3886
Mailing address
24 TRASK RD, PLYMOUTH, MA 02360-1725
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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