The Autism Spark Llc | |
30 Stefaniak Ave Webster MA 01570-2032 | |
(774) 232-4597 | |
Not Available |
Full Name | The Autism Spark Llc |
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Speciality | Behavior Analyst |
Location | 30 Stefaniak Ave, Webster, Massachusetts |
Authorized Official Name and Position | Cynthia Azu (CO-CHIEF EXECUTIVE OFFICER(CO-CEO)) |
Authorized Official Contact | 7742324597 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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The Autism Spark Llc 30 Stefaniak Ave Webster MA 01570-2032 Ph: (774) 232-4597 | The Autism Spark Llc 30 Stefaniak Ave Webster MA 01570-2032 Ph: (774) 232-4597 |
NPI Number | 1053888164 |
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Provider Enumeration Date | 10/26/2018 |
Last Update Date | 10/26/2018 |
Identifier | Type | State | Issuer |
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1053888164 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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