Individual
MIRANDA PRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
56 W MAIN ST, PLAINVILLE, CT 06062
(860) 351-5407
(860) 351-5774
Mailing address
56 W MAIN ST, PLAINVILLE, CT 06062-1904
(860) 351-5407
(860) 351-5774
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
BA.000868
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
07/19/2016
Last updated
10/07/2019
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