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NPI Profile for PETALUDA AUTISM SERVICES LLC in VERNON, CT.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Point of Service |
305S00000X |
| NPI # | 1245578475 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 01/23/2013 | |
| Last updated | 11/08/2014 - About 12 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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PETALU'DA AUTISM SERVICES LLC
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PETALU'DA AUTISM SERVICES LLC