Individual
COLLEEN DEMELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, BCBA
Contact information
Practice address
160 WEST ST, CROMWELL, CT 06416-2441
(860) 613-9930
(860) 613-9952
Mailing address
21 HICKORY LN, IVORYTON, CT 06442-1242
(860) 388-7575
(860) 767-1532
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001258
CT
103K00000X
Behavior Analyst
1-03-1264
CT
Other
Enumeration date
08/25/2010
Last updated
09/09/2011
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