Individual
HERMES KOLA ALAGBADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 CEDAR HILL ST, MARLBOROUGH, MA 01752-5900
(508) 410-3579
Mailing address
72 CHARLOTTE ST, WORCESTER, MA 01610-3458
(508) 410-3579
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SA1970967
MASS IDENTIFICATION
MA
Enumeration date
09/15/2022
Last updated
09/15/2022
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