Individual
MISS JENNA L WALLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S, BCBA
Contact information
Practice address
132 ROBBS HILL RD, LUNENBURG, MA 01462-2167
(978) 846-3318
Mailing address
41 THOMAS AVE, HAVERHILL, MA 01832-4468
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11832632
MA
Other
Enumeration date
06/11/2019
Last updated
06/15/2023
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