Individual
MICKELA LASANIA REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2666 STATE ST STE A3, HAMDEN, CT 06517-2232
(860) 544-0356
Mailing address
60 DONNA DR UNIT C2, NEW HAVEN, CT 06513-1446
(347) 399-3602
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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