Sam Avery Kopf

NPI #1154884302 in Waltham, Massachusetts

Provider Information

NPI Number: 1154884302
Entity Type: Individual
Name: Sam Avery Kopf
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 12, 2019
Last Updated: Apr 12, 2019

Practice Location

Address: 303 WYMAN ST
City: Waltham
State: Massachusetts
ZIP Code: 02451-1208
Phone: (800) 249-1266

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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