MEDICARE: SPRINGFIELD AREA PARENT CHILD CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	8015774	VT

General Provider Information

NPI Number	:	1558715029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRINGFIELD AREA PARENT CHILD CENTER

Provider Business Mailing Address
First Line	:	6 MAIN ST
Second Line	:
City	:	N SPRINGFIELD
State	:	VT
Zip	:	05150-9739
Country	:	US
Telephone Number	:	802-886-5242
Fax Number	:	802-886-2007

Provider Business Practice Location Address
First Line	:	6 MAIN ST
Second Line	:
City	:	N SPRINGFIELD
State	:	VT
Zip	:	05150-9739
Country	:	US
Telephone Number	:	802-886-5242
Fax Number	:	802-886-2007

Authorized Official
Title or Position	:	ADMINISTRATIVE MANAGER
Name	:	JAN ZONA
Credential	:
Telephone Number	:	80288615242

Provider Enumeration Date	:	04/20/2016
Last Update Date	:	04/20/2016

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Directions to “SPRINGFIELD AREA PARENT CHILD CENTER ” Practice Location

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