Individual
AVA ELISE AMENDOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 MAIN ST, GLASTONBURY, CT 06033-2218
(860) 430-1762
Mailing address
98 FAIRWAY DR, PORTLAND, CT 06480-1600
(860) 899-5761
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2338
CT
Other
Enumeration date
07/22/2026
Last updated
07/22/2026
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