| Abc-ct,llc | |
|
68 Wildemere Ave Waterbury CT 06705-1838 | |
| (617) 750-9398 | |
| (203) 841-1047 |
| Full Name | Abc-ct,llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 68 Wildemere Ave, Waterbury, Connecticut |
| Authorized Official Name and Position | Tarold Miller (CEO) |
| Authorized Official Contact | 6177509398 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Abc-ct,llc 68 Wildemere Ave Waterbury CT 06705-1838 Ph: (617) 750-9398 | Abc-ct,llc 68 Wildemere Ave Waterbury CT 06705-1838 Ph: (617) 750-9398 |
| NPI Number | 1831781954 |
|---|---|
| Provider Enumeration Date | 02/10/2021 |
| Last Update Date | 02/10/2021 |
| Certification Date | 02/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831781954 | NPI | - | NPPES |
| 4082 | Medicaid | CT | |
| 4082 | Other | CT | NON MEDICAID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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