Individual
CARRIE RENEE CICERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.ED, BCBA, LABA
Contact information
Practice address
232 N MAIN ST, EAST LONGMEADOW, MA 01028-1803
(413) 525-1500
Mailing address
146 ATWOODVILLE RD, MANSFIELD CENTER, CT 06250-1106
(860) 212-2077
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2684
MA
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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