Individual
MRS. JILLIAN KING BEVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, CTLBA
Contact information
Practice address
54 RIDGE RD, DURHAM, CT 06422-3414
(203) 213-3773
Mailing address
PO BOX 21, MIDDLEFIELD, CT 06455-0021
(203) 213-3773
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
CT
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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