Individual
MARISA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA,LBA
Contact information
Practice address
2300 MAIN ST, GLASTONBURY, CT 06033-2218
(860) 430-1762
Mailing address
52 OLD RESERVOIR RD, WETHERSFIELD, CT 06109-3532
(860) 490-7743
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1496
CT
Other
Enumeration date
09/05/2022
Last updated
09/05/2022
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