Provider Demographics
NPI:1104686443
Name:RANCE, ANDREW (BCBA, LABA)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:RANCE
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 1:7 HAZELWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1550
Mailing Address - Country:US
Mailing Address - Phone:978-930-6919
Mailing Address - Fax:
Practice Address - Street 1:51 UNION ST STE 320
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1147
Practice Address - Country:US
Practice Address - Phone:508-271-7704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3492103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst