Individual
AUDREY GIFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
97 DEREK DR, TOLLAND, CT 06084-2631
(860) 454-8649
Mailing address
97 DEREK DR, TOLLAND, CT 06084-2631
(860) 454-8649
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0082
MA
Other
Enumeration date
03/01/2016
Last updated
03/01/2016
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