Individual
ERICA BEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LABA
Contact information
Practice address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(617) 849-0836
Mailing address
14 ROLAND RD, WEYMOUTH, MA 02190-1023
(617) 849-0836
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2969
MA
Other
Enumeration date
11/10/2016
Last updated
07/28/2020
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