Individual
NICHOLE M BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
360 BLOOMFIELD AVE, SUITE 301, BLOOMFIELD, CT 06905
(860) 554-0899
Mailing address
25 ADAMS AVE UNIT 216, STAMFORD, CT 06902-3786
(203) 788-5482
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
13390377
CT
Other
Enumeration date
03/18/2019
Last updated
03/18/2019
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