Individual
MR. MICHAEL MAHONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
220 MAIN ST S, SOUTHBURY, CT 06488-2275
(203) 920-0520
Mailing address
129 WEDGEWOOD DR APT 2, WATERBURY, CT 06705-3673
(203) 510-7807
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
CT
Other
Enumeration date
12/17/2021
Last updated
12/17/2021
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