Samani Shyamindu Abekoongedara

Individual provider Active NPI Behavior Technician · East Hartford, CT

NPI 1689377665 · NPPES record last updated Mar 27, 2023

Key facts

NPI
1689377665
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
77 Hartland St Ste 108
East Hartford, CT 06108-3259
Phone
(888) 754-0398
NPI assigned
Mar 27, 2023
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

77 Hartland St Ste 108
East Hartford, CT 06108-3259

Mailing address

2110 Broadleaf Blvd
Manchester, CT 06042-7324
Phone (860) 830-5396

Other providers in East Hartford, CT

All providers in East Hartford, CT · Behavior Technician in Connecticut

Sources for this page

Verify at the official NPI Registry.