Provider Demographics
NPI:1447532437
Name:LEE SENES, CORAL (BCBA)
Entity type:Individual
Prefix:MRS
First Name:CORAL
Middle Name:
Last Name:LEE SENES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 WOOLSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4424
Mailing Address - Country:US
Mailing Address - Phone:203-400-2615
Mailing Address - Fax:
Practice Address - Street 1:54 WOOLSLEY AVE
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4424
Practice Address - Country:US
Practice Address - Phone:203-400-2615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-04-1689103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst