Petalu'da Autism Services Llc

NPI 1245578475 - Point of Service - 305S00000X

NPI Details
NPI 1245578475
Enumeration Date 01/23/2013
Last Updated 11/08/2014
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name KEISHA KEISHA
Position AUTISM THERAPIST
Phone (860) 983-8112
Fax
Practice Location
6 ELIZABETH LN
VERNON CT, 06066-5056, US
Phone (860) 983-8112
Fax
Business Location
6 ELIZABETH LN
VERNON CT, 06066-5056, US
Phone (860) 983-8112
Fax
Toxanomy
Taxonomy Code 305S00000X
License State Connecticut
License Number 3928518916
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According to our database, Petalu'da Autism Services Llc NPI is 1245578475, taxonomy code is 305S00000X and license number is 3928518916, license state is located at Connecticut. Petalu'da Autism Services Llc physically located at 6 Elizabeth Ln, Vernon CT, 06066-5056. NPI Number 1033115704 has the healthcare provider type.

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1245578475 NPI number is provided on an as is basis without warranty of any kind. 1245578475 is maintained by the National Plan & Provider Enumeration System. The contents of Petalu'da Autism Services Llc are for informational purposes only.