Individual
LISA BRAYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
158 STATE ST, MERIDEN, CT 06450-3202
(203) 237-7835
(203) 237-9187
Mailing address
158 STATE ST, MERIDEN, CT 06450-3202
(203) 237-7835
(203) 237-9187
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-11822
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004039657
—
CT
Enumeration date
07/23/2012
Last updated
07/23/2012
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