Marydinna Ekeh

Individual provider Active NPI Behavior Technician · Dudley, MA

NPI 1134936610 · NPPES record last updated Dec 17, 2024

Key facts

NPI
1134936610
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
30 Oxford Ave Apt 1a
Dudley, MA 01571-3279
Phone
(774) 502-1881
NPI assigned
Dec 17, 2024
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 Technician 106S00000X Yes

Addresses

Primary practice location

30 Oxford Ave Apt 1a
Dudley, MA 01571-3279

Mailing address

30 Oxford Ave Apt 1a
Dudley, MA 01571-3279
Phone (774) 502-1881

Other providers in Dudley, MA

All providers in Dudley, MA · Behavior Technician in Massachusetts

Sources for this page

Verify at the official NPI Registry.