| Springtide Child Development, Inc. | |
|
126 Monroe Tpke Trumbull CT 06611-1300 | |
| (781) 492-4991 | |
| (855) 217-6179 |
| Full Name | Springtide Child Development, Inc. |
|---|---|
| Speciality | Behavior Analyst |
| Location | 126 Monroe Tpke, Trumbull, Connecticut |
| Authorized Official Name and Position | Monica Hammel (CREDENTIALING MANAGER) |
| Authorized Official Contact | 7654615410 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Springtide Child Development, Inc. Po Box 740 Monroe CT 06468-0740 Ph: (203) 880-5495 | Springtide Child Development, Inc. 126 Monroe Tpke Trumbull CT 06611-1300 Ph: (781) 492-4991 |
| NPI Number | 1396383568 |
|---|---|
| Provider Enumeration Date | 12/18/2019 |
| Last Update Date | 12/14/2021 |
| Certification Date | 12/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396383568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | () | Primary |
| 225X00000X | Occupational Therapist | () | Secondary |
| 235Z00000X | Speech-language Pathologist | () | Secondary |
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