| Creative Potential Llc | |
|
1031 Norwich New London Tpke Unit 1o Uncasville CT 06382-1600 | |
| (860) 848-0514 | |
| (860) 848-0523 |
| Full Name | Creative Potential Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1031 Norwich New London Tpke Unit 1o, Uncasville, Connecticut |
| Authorized Official Name and Position | Sierra R Davis (OWNER) |
| Authorized Official Contact | 8608480514 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Potential Llc 1031 Norwich New London Tpke Unit 10 Uncasville CT 06382-1600 Ph: (860) 961-7238 | Creative Potential Llc 1031 Norwich New London Tpke Unit 1o Uncasville CT 06382-1600 Ph: (860) 848-0514 |
| NPI Number | 1730536996 |
|---|---|
| Provider Enumeration Date | 05/18/2016 |
| Last Update Date | 02/21/2020 |
| Certification Date | 02/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730536996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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