Individual
MR. MARCUS WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
220 ROUTE 12 STE 205, GROTON, CT 06340-3414
(877) 315-8080
Mailing address
220 ROUTE 12 STE 205, GROTON, CT 06340-3414
(877) 315-8080
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-27657
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-16-27657
BCBA
CT
Enumeration date
12/14/2017
Last updated
12/14/2017
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