Individual
MULLAI SRINIVASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2800 MAIN ST, GLASTONBURY, CT 06033-1091
(860) 430-1340
(860) 812-2399
Mailing address
2800 MAIN ST, GLASTONBURY, CT 06033-1091
(860) 430-1340
(860) 812-2399
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1301
CT
Other
Enumeration date
10/07/2021
Last updated
10/07/2021
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