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Individual

GLENROY PATRICK PATTERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BCBA

Contact information

Practice address
72 BIRCHWOOD RD, EAST HARTFORD, CT 06118-1702
(860) 206-9884
(860) 812-2399
Mailing address
72 BIRCHWOOD RD, EAST HARTFORD, CT 06118-1702
(860) 383-4423
(860) 383-4423

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103K00000X
Behavior Analyst
Primary
1-12-11741

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110026265
MA
Enumeration date
03/21/2013
Last updated
02/22/2019
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