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Individual

BARRY TERRELL OWENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
27 LESTON ST, MATTAPAN, MA 02126-1861
(857) 300-9779
Mailing address
27 LESTON ST, MATTAPAN, MA 02126-1861
(857) 300-9779

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
MA

Other

Enumeration date
01/11/2021
Last updated
01/11/2021
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