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Individual

ELIYAHU BARUCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
144 MAIN ST STE G, EAST HARTFORD, CT 06118-3239
(888) 754-0398
Mailing address
100 SUNSET CIR, FAIRFIELD, CT 06824-7643
(518) 522-0887

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1084
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
47-5420155
INBLOOM AUTISM SERVICES
CT
Enumeration date
12/17/2020
Last updated
12/17/2020
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