Provider Demographics
NPI:1467721050
Name:FISHER, BENJAMIN AARON (BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:AARON
Last Name:FISHER
Suffix:
Gender:M
Credentials:BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-1116
Mailing Address - Country:US
Mailing Address - Phone:508-479-7648
Mailing Address - Fax:
Practice Address - Street 1:167 WINTER ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MA
Practice Address - Zip Code:01721-1116
Practice Address - Country:US
Practice Address - Phone:508-479-7648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA95103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst