Individual
BLAKE GRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
51 WATER ST, SUITE 200, WATERTOWN, MA 02472-4611
(617) 923-7575
Mailing address
51 WATER ST, SUITE 200, WATERTOWN, MA 02472-4611
(617) 923-7575
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/15/2010
Last updated
08/28/2015
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