Healthcare Provider Details

I. General information

NPI: 1730815366
Provider Name (Legal Business Name): MIYA LUFF BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 FEDERAL RD UNIT L9L10
BROOKFIELD CT
06804-2418
US

IV. Provider business mailing address

304 FEDERAL RD UNIT L9L10
BROOKFIELD CT
06804-2418
US

V. Phone/Fax

Practice location:
  • Phone: 860-200-1100
  • Fax:
Mailing address:
  • Phone: 203-507-9301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2081
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: