Organization
SOMEWHERE OVER THE SPECTRUM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY WELCH MBA (CO-OWNER)
(860) 420-3800
Entity
Organization
Contact information
Practice address
120 WEBSTER SQUARE RD BLDG 1, BERLIN, CT 06037-2329
(860) 420-3800
(860) 420-3801
Mailing address
120 WEBSTER SQUARE RD BLDG 1, BERLIN, CT 06037-2329
(860) 420-3800
(860) 420-3801
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
174400000X
Specialist
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/11/2021
Last updated
09/10/2021
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