| The Developing And Aging Brain, Llc | |
|
246 Federal Rd Ste C23a Brookfield CT 06804-2640 | |
| (203) 364-4828 | |
| Not Available |
| Full Name | The Developing And Aging Brain, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 246 Federal Rd Ste C23a, Brookfield, Connecticut |
| Authorized Official Name and Position | Ashley N Simone (OWNER/MANAGER) |
| Authorized Official Contact | 2033644828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Developing And Aging Brain, Llc 246 Federal Rd Ste C23a Brookfield CT 06804-2640 Ph: (203) 364-4828 | The Developing And Aging Brain, Llc 246 Federal Rd Ste C23a Brookfield CT 06804-2640 Ph: (203) 364-4828 |
| NPI Number | 1104598978 |
|---|---|
| Provider Enumeration Date | 09/30/2021 |
| Last Update Date | 02/08/2022 |
| Certification Date | 02/08/2022 |
| Medicare PECOS PAC ID | 5092113381 |
|---|---|
| Medicare Enrollment ID | O20211019000136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104598978 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ashley N Simone |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194248609 PECOS PAC ID: 8628307527 Enrollment ID: I20190830002264 |
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