Individual
MISS MARISSA JOANNE DWYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2666 STATE STREET, UNTI A3, HAMDEN, CT 06517
(888) 754-0398
Mailing address
435 WINDY HILL RD, ORANGE, CT 06477-2142
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XGY014W03536
ANTHEM BLUE CROSS BLUE SHIELD
CT
Enumeration date
06/06/2022
Last updated
06/06/2022
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