Individual
TIVISAY VIANNY SANCHEZ BAEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9 GUAM RD APT E, CHELSEA, MA 02150-1428
(857) 452-9340
Mailing address
9 GUAM RD APT E, CHELSEA, MA 02150-1428
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100032116939
—
MA
01
—
XXP986655712
BLUE CROSS BLUE SHIELD
MA
Enumeration date
03/19/2018
Last updated
03/19/2018
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