Individual
MRS. DENAE JUSTINE GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 COURT ST STE 3, CROMWELL, CT 06416-1273
(860) 613-9930
Mailing address
110 COURT ST STE 3, CROMWELL, CT 06416-1273
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-29820
CT
103K00000X
Behavior Analyst
567
CT
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
08/07/2017
Last updated
05/19/2023
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