Individual
MR. LUCAS MONTEIRO FORTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
204 S FRANKLIN ST, HOLBROOK, MA 02343-1437
(508) 649-5952
Mailing address
204 S FRANKLIN ST, HOLBROOK, MA 02343-1437
(508) 649-5952
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
S11669895
MA
Other
Enumeration date
10/19/2017
Last updated
10/19/2017
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