Individual
CHRISTOPHER MCINNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
747 WESTERN AVE STE 2, MANCHESTER, ME 04351-3561
(207) 680-4790
Mailing address
15 SAUNDERS WAY STE 900, WESTBROOK, ME 04092-4836
(207) 878-9663
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-18-31112
BEHAVIORAL ANALYST CERTIFICATION BOARD
—
Enumeration date
07/10/2019
Last updated
07/10/2019
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