Individual
EMILY L ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41 PACELLA PARK DR, RANDOLPH, MA 02368-1755
(781) 440-0400
Mailing address
41 PACELLA PARK DR, RANDOLPH, MA 02368-1755
(781) 440-0400
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
05/24/2022
Last updated
05/24/2022
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