Derival, Magella

Derival, Magella is an sole proprietor health care provider with primary practice located at 13 Mercedes Vw , Roslindale MA 02131-4431. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Derival, Magella can be contacted via phone (857) 719-6450.

Contact Information

Primary practice address
13 Mercedes Vw Roslindale MA 02131-4431
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X S64405596 Massachusetts

Profile Details

NPI number 1992278006
LBN Legal business name Derival, Magella
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 10th, 2019
Last updated Jan 10th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992278006 NPPES
Massachusetts Other S64405596 LICENSE

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