Individual
JESSICA MARY MICHELE KANACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
29 MARION ST, WILMINGTON, MA 01887-3131
(617) 590-0059
Mailing address
29 MARION ST, WILMINGTON, MA 01887-3131
(617) 590-0059
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/15/2019
Last updated
03/15/2019
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