Individual
MAXIMILIAN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
62 AGNES DR, MANCHESTER, CT 06042-3426
(860) 993-2387
Mailing address
62 AGNES DR, MANCHESTER, CT 06042-3426
(860) 993-2387
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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