Amanda Blake

Individual provider Active NPI Behavior Analyst · Watertown, MA

NPI 1003330366 · NPPES record last updated Jul 28, 2017

Key facts

NPI
1003330366
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
Practice address
51 Water St
Watertown, MA 02472-4611
Phone
(617) 923-7575
NPI assigned
Jul 28, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Yes

Addresses

Primary practice location

51 Water St
Watertown, MA 02472-4611

Mailing address

51 Water St
Watertown, MA 02472-4611
Phone (617) 923-7575

Other providers in Watertown, MA

All providers in Watertown, MA · Behavior Analyst in Massachusetts

Sources for this page

Verify at the official NPI Registry.