Individual
SHIRA GORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17 BRAGG ST, EAST HARTFORD, CT 06108-2206
(860) 994-0613
Mailing address
17 BRAGG ST, EAST HARTFORD, CT 06108-2206
(860) 994-0613
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/10/2019
Last updated
01/10/2019
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