Samantha I Fazioli
NPI #1255824462 in Revere, Massachusetts
Provider Information
- NPI Number
- 1255824462
- Entity Type
- Individual
- Name
- Samantha I Fazioli
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Jun 12, 2018
- Last Updated
- Jun 12, 2018
Practice Location
- Address
- 481 REVERE ST APT 2
- City
- Revere
- State
- Massachusetts
- ZIP Code
- 02151-1500
- Phone
- (401) 500-3164
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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