Provider Demographics
NPI:1528549136
Name:POWERS, WERONIKA S (MA, BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:WERONIKA
Middle Name:S
Last Name:POWERS
Suffix:
Gender:F
Credentials:MA, BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BRIGHTSIDE LN
Mailing Address - Street 2:
Mailing Address - City:FORESTDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02644-1419
Mailing Address - Country:US
Mailing Address - Phone:508-209-4641
Mailing Address - Fax:
Practice Address - Street 1:14 BRIGHTSIDE LN
Practice Address - Street 2:
Practice Address - City:FORESTDALE
Practice Address - State:MA
Practice Address - Zip Code:02644-1419
Practice Address - Country:US
Practice Address - Phone:082-094-6415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst