Samuel Ajetomobi

Individual provider Active NPI Behavior Technician · Lunenburg, MA

NPI 1467095570 · NPPES record last updated Oct 21, 2019

Key facts

NPI
1467095570
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
132 Robbs Hill Rd
Lunenburg, MA 01462-2167
Phone
(857) 526-6056
NPI assigned
Oct 21, 2019
Sex
Male
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

132 Robbs Hill Rd
Lunenburg, MA 01462-2167

Mailing address

87 Willard St
New Bedford, MA 02744-1514
Phone (857) 526-6056

Other providers in Lunenburg, MA

All providers in Lunenburg, MA · Behavior Technician in Massachusetts

Sources for this page

Verify at the official NPI Registry.