Individual
TYNAESIA S PAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1207 ELLA T GRASSO BLVD APT B, NEW HAVEN, CT 06511-4280
(475) 355-9427
Mailing address
1207 ELLA T GRASSO BLVD APT B, NEW HAVEN, CT 06511-4280
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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