Individual
ALEXYS TAYLOR BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
144 MAIN ST STE G, EAST HARTFORD, CT 06118-3239
(888) 754-0398
Mailing address
631 TALCOTTVILLE RD APT N1, VERNON, CT 06066-2339
(860) 922-4599
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XGT0971816780
—
CT
Enumeration date
02/02/2022
Last updated
02/02/2022
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