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General NPI Number Information
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NPI Number | 1588203822
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Entity Type | Organization
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Legal Business Name | NATURALISTIC LEARNING CENTER LLC
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Dates
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Enumeration Date | 01/03/2020
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Last Update Date | 01/03/2020
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Provider Practice Location Address
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Address Line | 215 BRUSHY HILL RD
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City | DANBURY
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State | CT
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Zip | 06810-8430
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Country | US
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Telephone | 475-204-6410
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Fax | 203-826-2326
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Provider Business Mailing Address
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Address Line | PO BOX 139
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City | REDDING
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State | CT
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Zip | 06896-0139
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Country | US
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Telephone | 475-204-6410
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Fax | 203-826-2326
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Authorized Official
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Title or Position | CO-OWNER/ BCBA
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Name | LAUREN SHANLEY
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Credential | BCBA, LBA
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Telephone | 203-917-6185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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