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Individual

MRS. TRINA SARAH DIZON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, BCBA

Contact information

Practice address
110 COURT ST STE 3, CROMWELL, CT 06416-1273
(860) 613-9930
Mailing address
110 COURT ST STE 3, CROMWELL, CT 06416-1273

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-08-4750
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
223
STATE OF CONNECTICUT DEPARTMENT OF PUBLIC EHEALTH
CT
Enumeration date
01/07/2016
Last updated
05/23/2023
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