Individual
JESSICA TAVARES COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
160 FARMINGTON AVE, FARMINGTON, CT 06032-1728
(860) 495-0126
Mailing address
110 SKYRIDGE RD, BRISTOL, CT 06010-7253
(860) 371-4586
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
CT
Other
Enumeration date
12/15/2020
Last updated
12/15/2020
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