Provider Demographics
NPI:1558715029
Name:SPRINGFIELD AREA PARENT CHILD CENTER
Entity Type:Organization
Organization Name:SPRINGFIELD AREA PARENT CHILD CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:8028-861-5242
Mailing Address - Street 1:6 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:N SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05150-9739
Mailing Address - Country:US
Mailing Address - Phone:802-886-5242
Mailing Address - Fax:802-886-2007
Practice Address - Street 1:6 MAIN ST
Practice Address - Street 2:
Practice Address - City:N SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05150-9739
Practice Address - Country:US
Practice Address - Phone:802-886-5242
Practice Address - Fax:802-886-2007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT8015774235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty