Basic Information
| Provider Information | |||||||||
| NPI: | 1811484330 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARMOSINO | ||||||||
| FirstName: | AIMEE | ||||||||
| MiddleName: | CATALINA | ||||||||
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| Credential: | MS, LABA, BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 147 RANGEWAY RD UNIT 8102 | ||||||||
| Address2: | |||||||||
| City: | N BILLERICA | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018622063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7815521607 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 41 PACELLA PARK DR | ||||||||
| Address2: | |||||||||
| City: | RANDOLPH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023681755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7814400400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2018 | ||||||||
| LastUpdateDate: | 01/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-18-30068 | MA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.