Individual
MR. EDRINE KASASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 CEDAR HILL ST, MARLBOROUGH, MA 01752-5900
(000) 000-0000
(000) 000-0000
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
S69779857
MA
Other
Enumeration date
10/29/2018
Last updated
08/12/2024
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