James Clark, BCBA

Individual provider Active NPI Behavior Analyst · Auburn, MA

NPI 1962800516 · NPPES record last updated Dec 15, 2014

Key facts

NPI
1962800516
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-12-12285 (MA)
Practice address
65 Southbridge St
Auburn, MA 01501-2566
Phone
(774) 243-1179
Fax
(774) 243-1189
NPI assigned
Dec 15, 2014
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 Analyst 103K00000X 1-12-12285 MA Yes

Addresses

Primary practice location

65 Southbridge St
Auburn, MA 01501-2566

Mailing address

65 Southbridge St
Auburn, MA 01501-2566
Phone (774) 243-1179

Other providers in Auburn, MA

All providers in Auburn, MA · Behavior Analyst in Massachusetts

Sources for this page

Verify at the official NPI Registry.