Individual
LISA EDMONSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
46 CEDAR RD, SHREWSBURY, MA 01545-4401
(214) 763-9662
Mailing address
46 CEDAR ROAD, SHREWSBURY, MA 01545
(214) 763-9662
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-16054
MA
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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