Individual
TANIA ANN VIDOSEVIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
339 BOSTON POST RD, ORANGE, CT 06477-3560
(203) 671-1118
Mailing address
339 BOSTON POST RD, ORANGE, CT 06477-3560
(203) 671-1118
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
001260-1
NY
103K00000X
Behavior Analyst
Primary
273
CT
Other
Enumeration date
03/20/2019
Last updated
03/20/2019
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