Individual
EBEN COTTRELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
48 BOUNDARY RD, MALDEN, MA 02148-8321
(857) 265-1017
Mailing address
48 BOUNDARY RD, MALDEN, MA 02148-8321
(857) 265-1017
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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