Individual
EMMA ROSE NORTHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 WOODSTOCK AVE, PUTNAM, CT 06260-1431
(860) 888-0740
Mailing address
115 WOODSTOCK AVE, PUTNAM, CT 06260-1431
(860) 888-0740
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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