Individual
STACEY FRAGILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
377 MAIN ST APT 3, BROCKTON, MA 02301-5335
(908) 279-3784
Mailing address
377 MAIN ST APT 3, BROCKTON, MA 02301-5335
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/22/2019
Last updated
05/22/2019
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