Individual
MISS PAIGE AILEEN SANDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
162 WEST ST STE F, CROMWELL, CT 06416-4405
(860) 613-9930
(860) 613-9952
Mailing address
1435 BEDFORD ST APT 7D, STAMFORD, CT 06905-5217
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-21-48172
—
103K00000X
Behavior Analyst
Primary
1162
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-21-48172
BCBA
—
Enumeration date
03/08/2021
Last updated
06/11/2021
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