Individual
ASHANTI GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 SOUTH ST FL 2, WEST HARTFORD, CT 06110-1967
(860) 995-0787
Mailing address
53 NELSON ST APT D, HARTFORD, CT 06120-2070
(860) 995-0787
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
CT
Other
Enumeration date
04/06/2018
Last updated
04/06/2018
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