Provider Demographics
NPI:1790664365
Name:UBEN PAULINO, CRISSANNY
Entity type:Individual
Prefix:
First Name:CRISSANNY
Middle Name:
Last Name:UBEN PAULINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 JACKSON ST APT 3
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1646
Mailing Address - Country:US
Mailing Address - Phone:978-416-1432
Mailing Address - Fax:
Practice Address - Street 1:32 JACKSON ST APT 3
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1646
Practice Address - Country:US
Practice Address - Phone:978-416-1432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician