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Individual

SADI-ANN DUCKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
162 ROSELLE ST, BRIDGEPORT, CT 06604-1422
(203) 522-3439
Mailing address
160 ROSELLE ST, BRIDGEPORT, CT 06604-1422
(203) 522-3439

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-50200
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-21-50200
BEHAVIOR ANALYST CERTIFICATION BOARD
CT
01
1238
STATE LICENSE FROM DEPARTMENT OF PUBLIC HEALTH
CT
Enumeration date
09/06/2020
Last updated
03/30/2024
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