Individual
LANAE IVY LAROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
67 LIBERTY ST, APT B, DANVERS, MA 01923-3306
(781) 941-0759
Mailing address
67 LIBERTY ST, APT B, DANVERS, MA 01923-3306
(781) 941-0759
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
MA
Other
Enumeration date
01/27/2017
Last updated
01/27/2017
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