Organization
SUPER KIDS CLUB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY WIDDOWS LPC (DIRECTOR)
(203) 431-9150
Entity
Organization
Contact information
Practice address
898 ETHAN ALLEN HWY, SUITE 2, RIDGEFIELD, CT 06877-2813
(203) 431-9150
Mailing address
898 ETHAN ALLEN HWY, SUITE 2, RIDGEFIELD, CT 06877-2813
(203) 431-9150
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/13/2008
Last updated
05/13/2008
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