Individual
GREGORY RAYMOND WYLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA, LABA
Contact information
Practice address
47 E GROVE ST STE 102, MIDDLEBORO, MA 02346-1816
(800) 679-3609
Mailing address
209 MAIN ST APT C, BUZZARDS BAY, MA 02532-3264
(339) 236-0734
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LABA10000434
MA
Other
Enumeration date
03/20/2018
Last updated
10/05/2023
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