Individual
SHAYNE R ROBAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19 CLEMENT ST, WATERFORD, CT 06385-3003
(719) 766-1005
Mailing address
1169 POQUONNOCK RD, GROTON, CT 06340-4620
(719) 766-1005
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2085
CT
Other
Enumeration date
09/20/2023
Last updated
05/30/2025
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