Healthcare Provider Details

I. General information

NPI: 1437924826
Provider Name (Legal Business Name): KRISTINE LYNN MARINO-HARTMANN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 SKIFF ST
HAMDEN CT
06517-1016
US

IV. Provider business mailing address

42 LANTERN VIEW DR
NORTH BRANFORD CT
06471-1236
US

V. Phone/Fax

Practice location:
  • Phone: 203-498-6850
  • Fax: 203-498-6890
Mailing address:
  • Phone: 203-815-6384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number137
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: