Individual
BADR KISTAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
107 AUDUBON RD STE 160, WAKEFIELD, MA 01880-1245
(781) 502-5506
Mailing address
107 AUDUBON RD STE 160, WAKEFIELD, MA 01880-1245
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/29/2025
Last updated
07/29/2025
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