Individual
JORGE JORIE POLYNICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 LORNA RD # 2, MATTAPAN, MA 02126-2618
(617) 407-5242
Mailing address
55 LORNA RD # 2, MATTAPAN, MA 02126-2618
(617) 407-5242
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-4001
MA
Other
Enumeration date
05/08/2018
Last updated
05/08/2018
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