Individual
NICOLE GIWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBA
Contact information
Practice address
95 MAIN ST STE 2, EAST HAMPTON, CT 06424-1146
(860) 604-6729
Mailing address
158 LATHAM DR, GRISWOLD, CT 06351-3420
(203) 671-0240
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
123
CT
Other
Enumeration date
07/23/2020
Last updated
07/23/2020
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