Individual
MR. RUSSELL S BARD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
311 LOWELL ST, APT 2101, ANDOVER, MA 01810-4552
(978) 873-7653
Mailing address
311 LOWELL ST, APT 2101, ANDOVER, MA 01810-4552
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
101Y00000X
MA
Other
Enumeration date
12/23/2011
Last updated
12/23/2011
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