Individual
BETZAIDA FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
214 MAIN ST STE 1, MALDEN, MA 02148-6908
(617) 477-4050
(857) 244-6299
Mailing address
214 MAIN ST STE 1, MALDEN, MA 02148-6908
(954) 559-1221
(857) 244-6299
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-6937
—
103K00000X
Behavior Analyst
334
MA
103TC0700X
Clinical Psychologist
0972
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303414
—
MA
Enumeration date
12/18/2008
Last updated
04/09/2024
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