Ebony Portia Branch

NPI #1396211579 in Springfield, Massachusetts

Provider Information

NPI Number: 1396211579
Entity Type: Individual
Name: Ebony Portia Branch
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Oct 16, 2018
Last Updated: Oct 16, 2018

Practice Location

Address: 7 ARMORY ST APT 3
City: Springfield
State: Massachusetts
ZIP Code: 01105-1020
Phone: (141) 320-9640

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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