Individual
MS. SOPHIA GRACE WHITEWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3074 WHITNEY AVE BLDG 3, HAMDEN, CT 06518-2391
(203) 903-9363
Mailing address
3074 WHITNEY AVE BLDG 3, HAMDEN, CT 06518-2391
(203) 903-9363
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-26-512117
CT
Other
Enumeration date
08/04/2026
Last updated
08/04/2026
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