Individual
MADELINE FARIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LABA
Contact information
Practice address
201 WOODCREST DR, CHICOPEE, MA 01020-2043
(413) 335-4492
Mailing address
900 RIVERDALE ST UNIT 286, WEST SPRINGFIELD, MA 01089-4900
(413) 335-4492
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
3027-MH-B1
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
02/03/2017
Last updated
11/07/2022
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