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General NPI Number Information
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NPI Number | 1912111824
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Entity Type | Organization
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Legal Business Name | KIDZ MATTER LLC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 95 RAFFIA ROAD SUITE 2
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City | ENFIELD
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State | CT
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Zip | 06082
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Country | US
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Telephone | 860-749-9298
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Fax | 860-749-9298
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Provider Business Mailing Address
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Address Line | 95 RAFFIA ROAD SUITE 2
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City | ENFIELD
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State | CT
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Zip | 06082
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Country | US
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Telephone | 860-749-9298
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Fax | 860-749-9298
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Authorized Official
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Title or Position | OWNER-MANAGING MEMBER
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Name | MRS. JAYNE M NOEL
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Credential | LCSW
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Telephone | 860-749-9298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 005817
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | CT
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