Healthcare Provider Details

I. General information

NPI: 1952538324
Provider Name (Legal Business Name): DISCOVERING KIDS CONSULTATION SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 06/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 TURNER RD
BREMEN ME
04551-3327
US

IV. Provider business mailing address

234 TURNER RD
BREMEN ME
04551-3327
US

V. Phone/Fax

Practice location:
  • Phone: 207-529-2227
  • Fax: 207-529-2227
Mailing address:
  • Phone: 207-529-2227
  • Fax: 207-529-2227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number431578500
License Number StateME

VIII. Authorized Official

Name: MR. ALLEN J TOMASELLO
Title or Position: DIRECTOR
Credential: BCABA
Phone: 207-529-2227