| N/a | |
|
400 Robin St Bridgeport CT 06606-4442 | |
| (203) 530-9954 | |
| Not Available |
| Full Name | N/a |
|---|---|
| Speciality | Behavior Analyst |
| Location | 400 Robin St, Bridgeport, Connecticut |
| Authorized Official Name and Position | Nicole Marie Balkas (ABA; CEO) |
| Authorized Official Contact | 2035309954 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| N/a 400 Robin St Bridgeport CT 06606-4442 Ph: (203) 530-9954 | N/a 400 Robin St Bridgeport CT 06606-4442 Ph: (203) 530-9954 |
| NPI Number | 1093180929 |
|---|---|
| Provider Enumeration Date | 12/03/2015 |
| Last Update Date | 12/03/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093180929 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | () | Primary |
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