Organization
CHILD PRO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE ELIZABETH ALLEN MSED. (SPECIAL EDUCATION TEACHER)
(716) 646-1264
Entity
Organization
Contact information
Practice address
697 RIDGE RD, LACKAWANNA, NY 14218-1500
(716) 822-4781
Mailing address
697 RIDGE RD, LACKAWANNA, NY 14218-1500
(716) 822-4781
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
208888081
NY
Other
Enumeration date
06/21/2012
Last updated
06/21/2012
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