Individual
TYELER N CLASABLANCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
125 WHITING ST, NEW BRITAIN, CT 06051-3184
(888) 754-0398
Mailing address
5 TIMBERLEA DR, MERIDEN, CT 06450-6644
(203) 980-5936
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
179883593
CT
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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