Individual
TONI TIERRA WAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13 BOUCHET LN, NEW HAVEN, CT 06513-3412
(203) 464-8928
Mailing address
13 BOUCHET LN, NEW HAVEN, CT 06513-3412
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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