Basic Information
Provider Information
NPI: 1821469917
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FERRARO
FirstName: STEPHANIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: BCBA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 21600 OXNARD ST
Address2: SUITE 1800
City: WOODLAND HILLS
State: CA
PostalCode: 913674976
CountryCode: US
TelephoneNumber: 8183452345
FaxNumber: 8184490994
Practice Location
Address1: 331 MONTVALE AVE
Address2: 5TH FLOOR
City: WOBURN
State: MA
PostalCode: 018014675
CountryCode: US
TelephoneNumber: 7812817601
FaxNumber: 7816346209
Other Information
ProviderEnumerationDate: 10/14/2015
LastUpdateDate: 10/14/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X1-13-13614MAY Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


Home