Provider Demographics
NPI:1558665307
Name:GREENWOOD, AMBER (BCBA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 HAMMOND ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2161
Mailing Address - Country:US
Mailing Address - Phone:617-797-3151
Mailing Address - Fax:617-505-6184
Practice Address - Street 1:614 HAMMOND ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-2161
Practice Address - Country:US
Practice Address - Phone:617-797-3151
Practice Address - Fax:617-505-6184
Is Sole Proprietor?:No
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1096683103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst