Individual
GRETA LYNN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
144 MAIN ST STE G, EAST HARTFORD, CT 06118-3239
(888) 754-0398
Mailing address
144 MAIN ST, EAST HARTFORD, CT 06118-3239
(888) 754-0398
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
CT
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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