Individual
KELLY GANDOLFO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
Contact information
Practice address
256 TRAILSIDE WAY, ASHLAND, MA 01721-2356
(508) 395-7598
Mailing address
256 TRAILSIDE WAY, ASHLAND, MA 01721-2356
(508) 395-7598
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-14104
MA
Other
Enumeration date
12/05/2013
Last updated
12/05/2013
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