Organization
CONSTELLATION SCHOOL BASED THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON ALAN CREUTZMANN (ADMINISTRATOR)
(203) 663-6771
Entity
Organization
Contact information
Practice address
14 WESTPORT AVE, NORWALK, CT 06851-3915
(203) 663-6771
Mailing address
14 WESTPORT AVE, NORWALK, CT 06851-3915
(203) 663-6771
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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