Provider Demographics
NPI:1225514300
Name:O'FLAHERTY, CECILIA (BCBA, MED)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:O'FLAHERTY
Suffix:
Gender:F
Credentials:BCBA, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1396 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-1829
Mailing Address - Country:US
Mailing Address - Phone:816-872-4701
Mailing Address - Fax:
Practice Address - Street 1:397 RAILROAD STREET
Practice Address - Street 2:SUITE #4
Practice Address - City:ST. JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819
Practice Address - Country:US
Practice Address - Phone:802-999-2513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst