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General NPI Number Information
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NPI Number | 1023244266
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Entity Type | Organization
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Legal Business Name | CHILD DEVELOPMENT SERVICES SEARCH
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Dates
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Enumeration Date | 06/02/2009
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Last Update Date | 06/11/2009
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Provider Practice Location Address
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Address Line | 35A GURNET ROAD
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City | BRUNSWICK
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State | ME
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Zip | 04011-2744
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Country | US
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Telephone | 207-725-6365
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Fax | 207-725-4211
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Provider Business Mailing Address
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Address Line | 35A GURNET ROAD
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City | BRUNSWICK
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State | ME
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Zip | 04011-2744
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Country | US
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Telephone | 207-725-6365
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Fax | 207-725-4211
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Authorized Official
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Title or Position | DIRECTOR
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Name | ID GOSCINSKI
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Credential |
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Telephone | 207-725-6365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT2948
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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