Mikayla Bourgault

NPI #1134785702 in Worcester, Massachusetts

Provider Information

NPI Number: 1134785702
Entity Type: Individual
Name: Mikayla Bourgault
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: May 19, 2019
Last Updated: Dec 29, 2019

Practice Location

Address: 335A GREENWOOD ST
City: Worcester
State: Massachusetts
ZIP Code: 01607-1753
Phone: (508) 363-0200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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