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General NPI Number Information
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NPI Number | 1780490516
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Entity Type | Organization
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Legal Business Name | TG BEHAVIORAL HEALTH CONSULTANTS INC.
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Dates
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Enumeration Date | 12/06/2024
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 39 COURT ST
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City | PLATTSBURGH
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State | NY
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Zip | 12901-2801
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Country | US
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Telephone | 514-243-1354
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Fax |
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Provider Business Mailing Address
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Address Line | 10 MILLER ST UNIT 2141
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City | PLATTSBURGH
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State | NY
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Zip | 12901-4083
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Country | US
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Telephone | 514-243-1354
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. KOMLANTSE MEDAKPE GOSSOU
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Credential | PH.D., BCBA-D., LBA
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Telephone | 514-243-1354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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