Individual
CORAL ELISE STAGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
36 SNAKE MEADOW HILL RD, MOOSUP, CT 06354-1925
(860) 377-8386
Mailing address
36 SNAKE MEADOW HILL RD, MOOSUP, CT 06354-1925
(860) 377-8386
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/27/2024
Last updated
11/27/2024
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