Desdalin Cornelia Black, M.S.ED., BCBA
Individual provider Active NPI Behavior Analyst · Ayer, MA
NPI 1124368899 · NPPES record last updated Feb 18, 2013
Key facts
- NPI
- 1124368899
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 3 E Main St
Apt 2
Ayer, MA 01432-1605 - Phone
- (508) 717-1983
- NPI assigned
- Feb 18, 2013
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
3 E Main St
Apt 2
Ayer, MA 01432-1605
Mailing address
3 E Main St
Apt 2
Ayer, MA 01432-1605
Phone (508) 717-1983
Other providers in Ayer, MA
- Mary L Bakalos
- Steven Charles Balser
- Behavioral Milestones
- Marie G Bennett
- Elisha S Bernstein
- Colin Blake
- Jessica Winnie Blood
- Cheryl a. Boissy
- Therese Pelagie Bonok
- Abigail Bowen
All providers in Ayer, MA · Behavior Analyst in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.