Thai Lea IV

NPI #1083248561 in Lynn, Massachusetts

Provider Information

NPI Number: 1083248561
Entity Type: Individual
Name: Thai Lea IV
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Feb 24, 2020
Last Updated: Feb 24, 2020

Practice Location

Address: 25 HATHAWAY ST
City: Lynn
State: Massachusetts
ZIP Code: 01905-2753
Phone: (781) 346-4413

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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