Healthcare Provider Details

I. General information

NPI: 1508044272
Provider Name (Legal Business Name): LYNN BURNETTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 HALF MILE RD
NORTH HAVEN CT
06473
US

IV. Provider business mailing address

900 MAIN ST UNIT 2
OAKVILLE CT
06779-1999
US

V. Phone/Fax

Practice location:
  • Phone: 203-239-6425
  • Fax:
Mailing address:
  • Phone: 203-819-3352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number366
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: