MEDICARE: LYNN BURNETTE

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	103K00000X	Behavior Analyst	366	CT

General Provider Information

NPI Number	:	1508044272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN BURNETTE

Provider Business Mailing Address
First Line	:	900 MAIN ST UNIT 2
Second Line	:
City	:	OAKVILLE
State	:	CT
Zip	:	06779-1999
Country	:	US
Telephone Number	:	203-819-3352
Fax Number	:

Provider Business Practice Location Address
First Line	:	187 HALF MILE RD
Second Line	:
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473
Country	:	US
Telephone Number	:	203-239-6425
Fax Number	:

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

Provider Enumeration Date	:	02/05/2008
Last Update Date	:	06/02/2026

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Directions to “ LYNN BURNETTE ” Practice Location

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