Kayla Marie Bellanca, M.A., BCBA, LBA

Individual provider Active NPI Behavior Analyst · Cromwell, CT

NPI 1104468693 · NPPES record last updated Nov 15, 2019

Key facts

NPI
1104468693
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
869 (CT)
Practice address
162 West St Ste F
Cromwell, CT 06416-4405
Phone
(860) 613-9930
Fax
(860) 613-9952
NPI assigned
Oct 16, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X 869 CT
Behavior Analyst 103K00000X 869 CT Yes

Addresses

Primary practice location

162 West St Ste F
Cromwell, CT 06416-4405

Mailing address

162 West St Ste F
Cromwell, CT 06416-4405
Phone (860) 613-9930

Other providers in Cromwell, CT

All providers in Cromwell, CT · Behavior Analyst in Connecticut

Sources for this page

Verify at the official NPI Registry.