Organization
CBS THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER MATTESON (OFFICE MANAGER)
(401) 270-9991
Entity
Organization
Contact information
Practice address
626 PARK AVE, UNIT 2A, CRANSTON, RI 02910-2154
(401) 270-9991
Mailing address
626 PARK AVE, UNIT 2A, CRANSTON, RI 02910-2154
(401) 270-9991
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11313152
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063744043
—
RI
Enumeration date
10/09/2015
Last updated
10/09/2015
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