Organization
KIDTASTIC CONSULTING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAWNMARIE GARRETT MSED (PRESIDENT)
(631) 553-7952
Entity
Organization
Contact information
Practice address
62 BIRCH ST, LAKE GROVE, NY 11755-2743
(631) 553-7952
Mailing address
62 BIRCH ST, LAKE GROVE, NY 11755-2743
(631) 553-7952
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
210765081
NY
Other
Enumeration date
02/21/2009
Last updated
02/21/2009
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