Individual
AERIELLE BISONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21 MARBLE ST APT D, WORCESTER, MA 01603-2476
(508) 375-8782
Mailing address
21 MARBLE ST APT D, WORCESTER, MA 01603-2476
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
02/28/2019
Last updated
02/28/2019
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