Individual
DANIEL IVANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
139 CHARLES ST STE 388, BOSTON, MA 02114-3282
(203) 529-5123
Mailing address
16 TAYLOR PL, WESTPORT, CT 06880-4313
(203) 529-5123
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
3043
MA
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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