Individual
GRACE 0 MIANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
461 RIVER RD, ANDOVER, MA 01810-4349
(978) 654-4300
Mailing address
25 MARLBORO RD, GEORGETOWN, MA 01833-2211
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861568107
OTHER
—
Enumeration date
01/11/2023
Last updated
01/11/2023
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