Individual
BREANNA MONA BOSTICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
112 WEST AVE, WILLIMANTIC, CT 06226-1919
(860) 303-2701
Mailing address
112 WEST AVE, WILLIMANTIC, CT 06226-1919
(860) 303-2701
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/15/2026
Last updated
06/15/2026
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