Individual
TALIA HOPE BLAISDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
39 MAIN ST, LUNENBURG, MA 01462-1428
(978) 956-3200
Mailing address
120 MECHANIC ST STE B, UPTON, MA 01568-1578
(508) 922-9506
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2975
MA
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
06/06/2012
Last updated
02/05/2024
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