Individual
LEANNA HARTNACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
187 HALF MILE RD, NORTH HAVEN, CT 06473-4121
(203) 234-8454
Mailing address
274 LENOX ST UNIT 1, NEW HAVEN, CT 06513-4016
(203) 927-9712
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14085701
CAQH
CT
Enumeration date
09/26/2017
Last updated
09/26/2017
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