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General NPI Number Information
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NPI Number | 1518590116
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Entity Type | Organization
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Legal Business Name | THE GROWING TREE INSTITUTE LLC
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Dates
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Enumeration Date | 02/21/2020
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 12 MAIN ST STE 2
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City | ELLINGTON
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State | CT
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Zip | 06029-3361
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Country | US
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Telephone | 860-730-4176
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Fax | 860-469-2714
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Provider Business Mailing Address
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Address Line | 12 MAIN ST STE 2
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City | ELLINGTON
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State | CT
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Zip | 06029-3361
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | JACQUELINE WOOD
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Credential |
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Telephone | 860-712-4550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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