Provider Demographics
NPI:1659034296
Name:CANTY, ALYNDRA BAHAM
Entity Type:Individual
Prefix:
First Name:ALYNDRA
Middle Name:BAHAM
Last Name:CANTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-0094
Mailing Address - Country:US
Mailing Address - Phone:908-285-7858
Mailing Address - Fax:
Practice Address - Street 1:6 STERLING DR
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-2694
Practice Address - Country:US
Practice Address - Phone:908-285-7858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-20-43693103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA15423625OtherN/A
NAOtherNA