Individual
DORIS EVE CASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
758R COLONEL LEDYARD HWY, LEDYARD, CT 06339-1570
(860) 995-9082
Mailing address
10 BEL AIRE DR, MYSTIC, CT 06355-2002
(860) 910-8476
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB442704
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558808105
—
CT
Enumeration date
09/01/2021
Last updated
09/01/2021
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