Individual
LAWRENCE VENUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
55 LISBON ST, WATERTOWN, CT 06795-2669
(860) 294-1543
(860) 417-3805
Mailing address
55 LISBON ST, WATERTOWN, CT 06795-2669
(860) 294-1543
(860) 417-3805
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-03-1454
CT
Other
Enumeration date
06/06/2011
Last updated
06/06/2011
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