Individual
KELLY SOUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., BCBA, LABA
Contact information
Practice address
75 ABORN ST # 3, PEABODY, MA 01960-5657
(781) 726-0261
Mailing address
75 ABORN ST # 3, PEABODY, MA 01960-5657
(781) 726-0261
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1016
MA
Other
Enumeration date
05/18/2017
Last updated
07/21/2022
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