Individual
IAN P BURRUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
279 NEW BRITAIN RD STE 9, BERLIN, CT 06037-3165
(860) 827-9364
Mailing address
PO BOX 984, NEW BRITAIN, CT 06050-0984
(860) 827-9364
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-7394
CO
Other
Enumeration date
02/23/2013
Last updated
02/23/2013
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