Provider Demographics
NPI:1144675042
Name:DONATIELLO, CHRISTINA G (MSED, BCBA, LABA)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:G
Last Name:DONATIELLO
Suffix:
Gender:F
Credentials:MSED, BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:109 OAK ST
Mailing Address - Street 2:SUITE G-10
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02464-1492
Mailing Address - Country:US
Mailing Address - Phone:617-467-5849
Mailing Address - Fax:617-916-5081
Practice Address - Street 1:109 OAK ST
Practice Address - Street 2:SUITE G-10
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02464-1492
Practice Address - Country:US
Practice Address - Phone:617-467-5849
Practice Address - Fax:617-916-5081
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-12-11496103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst