Individual
AMANDA RUTH DERBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 WARREN ST, BRIGHTON, MA 02135-3602
(617) 254-3800
Mailing address
30 WARREN ST, BRIGHTON, MA 02135-3602
(617) 254-3800
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
03/29/2018
Last updated
07/28/2022
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