Individual
MR. PATRICK ADAM MALLOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA, LABA
Contact information
Practice address
345A GREENWOOD ST, WORCESTER, MA 01607-1753
(508) 363-0200
Mailing address
345A GREENWOOD ST, WORCESTER, MA 01607-1753
(508) 363-0200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1772
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-16-24717
BOARD CERTIFICATE IN APPLIED BEHAVIOR ANALYSIS
—
Enumeration date
06/23/2014
Last updated
03/01/2021
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