Ditullio, Brandon Robert

Ditullio, Brandon Robert is an individual health care provider with primary practice located at 345 Greenwood St Ste A , Worcester MA 01607-1767. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Ditullio, Brandon Robert can be contacted via phone (508) 363-0200.

Contact Information

Primary practice address
345 Greenwood St Ste A Worcester MA 01607-1767
Phone: (508) 363-0200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 2516 Massachusetts

Profile Details

NPI number 1831461151
LBN Legal business name Ditullio, Brandon Robert
Credentials MS., BCBA, LABA.
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2012
Last updated Jan 7th, 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 1831461151 NPPES
Massachusetts Other 1303287 MBHP
Massachusetts Other 1004745 MBHP
Massachusetts Other M18633 MBHP
Massachusetts Other 0000023532 MBHP
Massachusetts MEDICAID 1303287 MBHP
Massachusetts Other 042611055 MBHP
Massachusetts Other 99618201 MBHP

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