Individual
LAUREN SHANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
91 GREENWOOD AVE, BETHEL, CT 06801-2529
(860) 946-0362
Mailing address
91 GREENWOOD AVE, BETHEL, CT 06801-2529
(860) 946-0362
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-29108
CT
Other
Enumeration date
12/22/2017
Last updated
10/23/2019
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