Provider Demographics
NPI:1437492790
Name:MAYFLOWER BEHAVIOR ANALYSIS LLC
Entity Type:Organization
Organization Name:MAYFLOWER BEHAVIOR ANALYSIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:818-859-3742
Mailing Address - Street 1:36 DIGHTON ST APT 5
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3227
Mailing Address - Country:US
Mailing Address - Phone:818-859-3742
Mailing Address - Fax:
Practice Address - Street 1:36 DIGHTON ST APT 5
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3227
Practice Address - Country:US
Practice Address - Phone:818-859-3742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health