Kelly Gandolfo, M.S., BCBA
Individual provider Active NPI Behavior Analyst · Ashland, MA
NPI 1457782245 · NPPES record last updated Dec 5, 2013
Key facts
- NPI
- 1457782245
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-13-14104 (MA)
- Practice address
- 256 Trailside Way
Ashland, MA 01721-2356 - Phone
- (508) 395-7598
- NPI assigned
- Dec 5, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-13-14104 | MA | Yes |
Addresses
Primary practice location
256 Trailside Way
Ashland, MA 01721-2356
Mailing address
256 Trailside Way
Ashland, MA 01721-2356
Phone (508) 395-7598
Other providers in Ashland, MA
- Lauren Marie Foody
- Leah Forristall
- Meredith Furhman Smith
- McKenna Culla Galaher
- Janet L Gamache
- Ellen Gellineau
- Reshma Jayant Ghanekar
- Rachael Gilardetti
- Meredith Jayne Gingrich
- Jayme Goldman
All providers in Ashland, 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 Dec 5, 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.