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General NPI Number Information
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NPI Number | 1801279492
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Entity Type | Organization
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Legal Business Name | SWIM WHISPERERS SWIM SCHOOL NEW ENGLAND
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Dates
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Enumeration Date | 07/01/2015
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Last Update Date | 07/01/2015
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Provider Practice Location Address
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Address Line | 1177 HIGH RIDGE RD STE 116
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City | STAMFORD
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State | CT
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Zip | 06905-1221
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Country | US
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Telephone | 203-545-0024
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Fax |
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Provider Business Mailing Address
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Address Line | 1177 HIGH RIDGE RD STE 116
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City | STAMFORD
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State | CT
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Zip | 06905-1221
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Country | US
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Telephone | 203-545-0024
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Fax |
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Authorized Official
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Title or Position | COOWNER
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Name | MRS. AILENE DEBRA TISSER
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Credential | MA PT
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Telephone | 203-969-6431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 10221
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 10846
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 9353
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 10221
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 11053
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License Number State | MA
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