Individual
BETINA MARIE CORNWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
95 WOLF HARBOR RD, MILFORD, CT 06461-1938
(203) 882-8439
Mailing address
383 ARBUTUS ST, MIDDLETOWN, CT 06457-7102
(860) 301-2621
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1159
CT
Other
Enumeration date
04/16/2021
Last updated
04/16/2021
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