Healthcare Provider Details

I. General information

NPI: 1548872898
Provider Name (Legal Business Name): AYNSLEY GUERTIN MSED, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 FAIR ST
WALLINGFORD CT
06492-4208
US

IV. Provider business mailing address

373 WARD ST
WALLINGFORD CT
06492-4614
US

V. Phone/Fax

Practice location:
  • Phone: 475-303-2473
  • Fax:
Mailing address:
  • Phone: 475-303-2473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number3435
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number003242712A
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-44030
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1727
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: