MEDICARE: KRISTIN F WESLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1033083241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN F WESLEY

Provider Business Mailing Address
First Line	:	73B CARILLON DR
Second Line	:
City	:	ROCKY HILL
State	:	CT
Zip	:	06067-2501
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	73B CARILLON DR
Second Line	:
City	:	ROCKY HILL
State	:	CT
Zip	:	06067-2501
Country	:	US
Telephone Number	:	917-284-9393
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2025
Last Update Date	:	10/24/2025

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