| NPI | 1124689922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ALAN CREUTZMANN Administrator 203-663-6771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2019-06-24 |