Provider Demographics
NPI:1083387310
Name:JAMES, MOLLY (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BELLVISTA RD APT 1
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-7612
Mailing Address - Country:US
Mailing Address - Phone:210-834-4983
Mailing Address - Fax:
Practice Address - Street 1:6 BELLVISTA RD APT 1
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135-7612
Practice Address - Country:US
Practice Address - Phone:210-834-4983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty