Healthcare Provider Details

I. General information

NPI: 1255682035
Provider Name (Legal Business Name): ELIZABETH ZVINGILAS BROWN M.S., B.C.B.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2012
Last Update Date: 09/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 PUTNAM ROAD
WAUREGAN CT
06387-0378
US

IV. Provider business mailing address

P.O. BOX 839 1007 NORTH MAIN STREET
DAYVILLE CT
06241-0839
US

V. Phone/Fax

Practice location:
  • Phone: 860-412-8686
  • Fax:
Mailing address:
  • Phone: 860-774-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-11-8914
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: