Healthcare Provider Details

I. General information

NPI: 1538430863
Provider Name (Legal Business Name): NUTRITIONAL AND BEHAVIORAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2012
Last Update Date: 01/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 DANBURY RD SUITE 4
RIDGEFIELD CT
06877-3227
US

IV. Provider business mailing address

158 DANBURY RD SUITE 4
RIDGEFIELD CT
06877-3227
US

V. Phone/Fax

Practice location:
  • Phone: 203-431-3438
  • Fax:
Mailing address:
  • Phone: 203-431-3438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROSALIE SCHIAPPCASSE-JANETTE
Title or Position: NUTRITIONIST / PSYCHOTHERAPIST
Credential: MS, MSW
Phone: 203-431-3438