Individual
BRIAN MCGOVERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
18 IMPERIAL PL UNIT 3C, PROVIDENCE, RI 02903-4643
(401) 523-1401
Mailing address
18 IMPERIAL PL UNIT 3C, PROVIDENCE, RI 02903-4643
(401) 523-1401
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-10129
RI
Other
Enumeration date
09/30/2014
Last updated
09/30/2014
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