MEDICARE: AALIYAH ENGRAM

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		CT

General Provider Information

NPI Number	:	1174461065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AALIYAH ENGRAM

Provider Business Mailing Address
First Line	:	832 THOMPSONVILLE RD
Second Line	:
City	:	SUFFIELD
State	:	CT
Zip	:	06078-1442
Country	:	US
Telephone Number	:	860-849-4524
Fax Number	:

Provider Business Practice Location Address
First Line	:	360 BLOOMFIELD AVE STE 301
Second Line	:
City	:	WINDSOR
State	:	CT
Zip	:	06095-2700
Country	:	US
Telephone Number	:	888-880-9270
Fax Number	:	866-500-2186

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

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “ AALIYAH ENGRAM ” Practice Location

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