Individual
VANESSA MERVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
174 RIDGE RD, REVERE, MA 02151-3825
(857) 701-2269
Mailing address
174 RIDGE RD, REVERE, MA 02151-3825
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
06/12/2019
Last updated
06/12/2019
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