Individual
SUZANNE ELY KAMINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
1040 WALTHAM ST, LEXINGTON, MA 02421-8033
(781) 761-5077
(781) 862-4979
Mailing address
1040 WALTHAM ST, LEXINGTON, MA 02421-8033
(781) 761-5077
(781) 862-4979
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000023532
BMC
MA
01
—
042611055
TAX ID
MA
01
—
1004745
NHP
MA
01
—
1303287
MBHP
MA
05
—
1303287
—
MA
01
—
99618201
NETWORK HEALTH
MA
01
—
M18633
BCBS
MA
Enumeration date
04/02/2013
Last updated
04/02/2013
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