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General NPI Number Information
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NPI Number | 1306083977
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Entity Type | Organization
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Legal Business Name | DEVELOPMENTAL SKILL BUILDERS. LLC
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Dates
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Enumeration Date | 01/19/2009
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Last Update Date | 01/19/2009
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Provider Practice Location Address
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Address Line | 9 GEORGE ST
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City | RENSSELAER
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State | NY
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Zip | 12144-1206
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Country | US
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Telephone | 518-258-7364
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Fax |
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Provider Business Mailing Address
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Address Line | 9 GEORGE ST
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City | RENSSELAER
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State | NY
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Zip | 12144-1206
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Country | US
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Telephone | 518-258-7364
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Fax |
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Authorized Official
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Title or Position | OWNER/EVALUATOR
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Name | MS. MARY THERESE DUNCAN
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Credential | MS ED
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Telephone | 518-258-7364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 097549413
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License Number State | NY
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