Individual
MS. SAMANTHA ELSA GRASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
89 CEDAR LAKE RD, CHESTER, CT 06412-1008
(860) 388-8862
Mailing address
89 CEDAR LAKE RD, CHESTER, CT 06412-1008
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-19726
CT
Other
Enumeration date
04/04/2017
Last updated
04/04/2017
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