Individual
MR. MICHAEL DEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6 WILLIAMS DR, PROSPECT, CT 06712-1342
(203) 217-4811
Mailing address
6 WILLIAMS DR, PROSPECT, CT 06712-1342
(203) 217-4811
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-17626
CT
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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