Individual
BREANNAH KATRICE DAVIS-BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
56 W MAIN ST, PLAINVILLE, CT 06062-1904
(336) 918-6033
Mailing address
56 W MAIN ST, PLAINVILLE, CT 06062-1904
(336) 918-6033
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1133
CT
Other
Enumeration date
03/16/2021
Last updated
03/16/2021
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