Provider Demographics
NPI:1346672177
Name:CONNORS, DENISE A (BCBA, LABA)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:A
Last Name:CONNORS
Suffix:
Gender:F
Credentials:BCBA, LABA
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:A
Other - Last Name:DIPIETRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-2934
Mailing Address - Country:US
Mailing Address - Phone:617-750-5250
Mailing Address - Fax:
Practice Address - Street 1:134 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUZZARDS BAY
Practice Address - State:MA
Practice Address - Zip Code:02532-3221
Practice Address - Country:US
Practice Address - Phone:617-750-5250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-03
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA743236230103K00000X
MA2517103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst