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General NPI Number Information
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NPI Number | 1740909019
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Entity Type | Individual
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Provider Name | MARISA MARGARET REIFSCHNEIDER BCBA
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Gender | Female
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 737 MAIN ST
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City | WATERTOWN
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State | CT
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Zip | 06795-2624
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Country | US
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Telephone | 203-525-5364
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Fax |
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Provider Business Mailing Address
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Address Line | 130 DALTON ST
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City | OAKVILLE
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State | CT
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Zip | 06779-1145
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Country | US
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Telephone | 203-885-2421
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1195
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License Number State | CT
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