Individual
REINA SANTIAGO CEDENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
93 TWIN OAKS VLG, MANSFIELD, MA 02048-1533
(413) 212-1535
Mailing address
93 TWIN OAKS VLG, MANSFIELD, MA 02048-1533
(413) 212-1535
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-19-100858
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KIH337W09170
BLUE SHIELD
—
Enumeration date
10/05/2021
Last updated
10/05/2021
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