Provider Demographics
NPI:1801421425
Name:LONARDO, ANNA MARIE (BCBA, LBA)
Entity type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:MARIE
Last Name:LONARDO
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 STATE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-3108
Mailing Address - Country:US
Mailing Address - Phone:203-710-4228
Mailing Address - Fax:
Practice Address - Street 1:350 STATE ST
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-3108
Practice Address - Country:US
Practice Address - Phone:203-710-4228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-19-37695103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst