Individual
MICHAEL FRITZ HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
567 FOREST ST, EAST HARTFORD, CT 06118-2036
(860) 202-3366
Mailing address
567 FOREST ST, EAST HARTFORD, CT 06118-2036
(860) 202-3366
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA.001268
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BA.001268
BEHAVIOR ANALYST
CT
Enumeration date
11/23/2021
Last updated
11/23/2021
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