Lucas Monteiro Fortes

Individual provider Active NPI Behavior Analyst · Holbrook, MA

NPI 1639680465 · NPPES record last updated Oct 19, 2017

Key facts

NPI
1639680465
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
S11669895 (MA)
Practice address
204 S Franklin St
Holbrook, MA 02343-1437
Phone
(508) 649-5952
NPI assigned
Oct 19, 2017
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

State licenses

LicenseStateTypeSpecialty
S11669895MAMDBehavioral Analyst

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X S11669895 MA Yes

Addresses

Primary practice location

204 S Franklin St
Holbrook, MA 02343-1437

Mailing address

204 S Franklin St
Holbrook, MA 02343-1437
Phone (508) 649-5952

Other providers in Holbrook, MA

All providers in Holbrook, MA · Behavior Analyst in Massachusetts

Sources for this page

Verify at the official NPI Registry.