| Constellation School Based Therapy, LLC | |
|
14 Westport Ave Norwalk CT 06851-3915 | |
| (203) 663-6771 | |
| Not Available |
| Full Name | Constellation School Based Therapy, LLC |
|---|---|
| Speciality | Behavior Analyst |
| Location | 14 Westport Ave, Norwalk, Connecticut |
| Authorized Official Name and Position | Jason Alan Creutzmann (ADMINISTRATOR) |
| Authorized Official Contact | 2036636771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Constellation School Based Therapy, LLC 14 Westport Ave Norwalk CT 06851-3915 Ph: (203) 663-6771 | Constellation School Based Therapy, LLC 14 Westport Ave Norwalk CT 06851-3915 Ph: (203) 663-6771 |
| NPI Number | 1124689922 |
|---|---|
| Provider Enumeration Date | 06/24/2019 |
| Last Update Date | 06/24/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124689922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | () | Primary |
| 251S00000X | Community/behavioral Health | () | Secondary |
| 252Y00000X | Early Intervention Provider Agency | () | Secondary |
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