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General NPI Number Information
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NPI Number | 1821384421
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Entity Type | Organization
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Legal Business Name | REDWING SERVICES, INC.
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 3 FRONT ST LOWER MILL SUITE 404
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City | ROLLINSFORD
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State | NH
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Zip | 03869-7001
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Country | US
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Telephone | 207-752-2709
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 482
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City | ROLLINSFORD
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State | NH
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Zip | 03869-0482
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Country | US
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Telephone | 207-752-2709
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. KRISTINA FUNK SCHLIESTETT
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Credential | M.ED., BCBA
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Telephone | 207-752-2709
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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 | 1-09-5668
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP1283
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 0885
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License Number State | NH
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Taxonomy #4
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-09-5668
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License Number State | ME
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