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
Phone: (857) 719-6450
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992278006 | NPPES |
| Massachusetts | Other | S64405596 | LICENSE |
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