Individual
MISS KEANNA MICKUNE SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 OLD CANAL DR, LOWELL, MA 01851-2730
(978) 452-1736
(978) 458-1428
Mailing address
22 OLD CANAL DR, LOWELL, MA 01851-2730
(978) 452-1736
(978) 458-1428
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/08/2017
Last updated
02/10/2017
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