Healthcare Provider Details

I. General information

NPI: 1609310408
Provider Name (Legal Business Name): BARBARA MICHALEK BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2016
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34-3 SHUNPIKE RD
CROMWELL CT
06416-2490
US

IV. Provider business mailing address

34-3 SHUNPIKE RD
CROMWELL CT
06416-2490
US

V. Phone/Fax

Practice location:
  • Phone: 860-224-6342
  • Fax:
Mailing address:
  • Phone: 860-224-6342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0-13-2474
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: