Individual
EDWIN RAUL DEJESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 CENTERPOINT DR STE 243, MIDDLETOWN, CT 06457-7568
(855) 295-3276
Mailing address
101 CENTERPOINT DR STE 243, MIDDLETOWN, CT 06457-7568
(855) 295-3276
(818) 241-6853
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/27/2020
Last updated
01/27/2020
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