Healthcare Provider Details

I. General information

NPI: 1104746957
Provider Name (Legal Business Name): EVELYNNE MARNIELLE SAINT-VAL RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 MAIN ST STE G1
BRIDGEPORT CT
06606-4237
US

IV. Provider business mailing address

47 ROSLYN TER
BRIDGEPORT CT
06606-2841
US

V. Phone/Fax

Practice location:
  • Phone: 877-222-0399
  • Fax:
Mailing address:
  • Phone: 203-360-7989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-508620
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: