| Stonebridge Behavioral Services | |
|
16 Bridge Gate Plymouth MA 02360-6377 | |
| (508) 287-8692 | |
| (508) 591-7886 |
| Full Name | Stonebridge Behavioral Services |
|---|---|
| Speciality | Behavior Analyst |
| Location | 16 Bridge Gate, Plymouth, Massachusetts |
| Authorized Official Name and Position | Gordon Anthony Defalco (OWNER/PRESIDENT) |
| Authorized Official Contact | 5082878692 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stonebridge Behavioral Services 16 Bridge Gate Plymouth MA 02360-6377 Ph: (508) 287-8692 | Stonebridge Behavioral Services 16 Bridge Gate Plymouth MA 02360-6377 Ph: (508) 287-8692 |
| NPI Number | 1679829162 |
|---|---|
| Provider Enumeration Date | 08/02/2012 |
| Last Update Date | 08/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679829162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-04-1493 (* (Not Available)) | Primary |
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