Individual
MARISABEL PORTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 OAK ST, NEWTON, MA 02464-1492
(617) 467-4523
Mailing address
14 DERBY ST, NEWTON, MA 02465-1622
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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