Individual
CORRINA E DESAUTELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
770 SAYBROOK RD UNIT B4, MIDDLETOWN, CT 06457-4739
(828) 785-9471
Mailing address
80 PROSPECT ST APT 1, MIDDLETOWN, CT 06457-2624
(864) 301-5306
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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