Provider Demographics
NPI:1689236820
Name:ANDREWS, AMELIA BEATRICE (BCBA)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:BEATRICE
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:BEATRICE
Other - Last Name:DESJARDINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:1 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:ERVING
Mailing Address - State:MA
Mailing Address - Zip Code:01344-4403
Mailing Address - Country:US
Mailing Address - Phone:413-776-4422
Mailing Address - Fax:
Practice Address - Street 1:1 RIVER ST
Practice Address - Street 2:
Practice Address - City:ERVING
Practice Address - State:MA
Practice Address - Zip Code:01344-4403
Practice Address - Country:US
Practice Address - Phone:413-776-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2024-12-19
Deactivation Date:2021-04-27
Deactivation Code:
Reactivation Date:2021-05-18
Provider Licenses
StateLicense IDTaxonomies
106S00000X
NH1-21-49462103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician