Individual
DORCALY JISSEL FIALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 METHUEN ST FL 2, LAWRENCE, MA 01840-1700
(917) 703-6958
Mailing address
44 DARIUS ST, METHUEN, MA 01844-3208
(917) 703-6958
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
11/13/2016
Last updated
11/13/2016
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