Individual
JASON J STAUFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2800 MAIN ST, GLASTONBURY, CT 06033-1036
(604) 301-3408
Mailing address
2121 TOWN RDG, MIDDLETOWN, CT 06457-1649
(718) 869-0102
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
629
CT
174400000X
Specialist
670387121
NY
Other
Enumeration date
05/18/2013
Last updated
09/04/2019
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