Provider Demographics
NPI:1780488361
Name:BEDOYA, JOSE ALEXANDER (BCBA, LABA)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:ALEXANDER
Last Name:BEDOYA
Suffix:
Gender:
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 1:7 CYPRESS DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4907
Mailing Address - Country:US
Mailing Address - Phone:781-328-0951
Mailing Address - Fax:
Practice Address - Street 1:7 CYPRESS DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4907
Practice Address - Country:US
Practice Address - Phone:781-328-0951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-24-76593106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician