Individual
KRISTINA GEORGIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
330 COLONEL LEDYARD HWY, LEDYARD, CT 06339-1910
(877) 315-8080
Mailing address
104 HARTFORD RD, SALEM, CT 06420-3841
(860) 861-4373
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/01/2018
Last updated
07/01/2018
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