Organization
TDAT TRANSITIONAL DEVELOPMENT AND TRAINING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOSHIREA JACKSON (PARTNER/OWNER)
(203) 650-4681
Entity
Organization
Contact information
Practice address
70 LINCOLN BLVD, BRIDGEPORT, CT 06606-5550
(203) 650-4681
Mailing address
70 LINCOLN BLVD, BRIDGEPORT, CT 06606-5550
(203) 650-4681
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
02/07/2012
Last updated
02/22/2012
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