Individual
COLEEN E BRAKENWAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
62 PROVIDENCE PIKE STE E, PUTNAM, CT 06260-2415
(888) 805-0759
Mailing address
166 HALLS HILL RD, DANIELSON, CT 06239-3319
(860) 608-8088
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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