Provider Demographics
NPI:1689079170
Name:CONNECTIONS FAMILY-CENTERED THERAPIES
Entity Type:Organization
Organization Name:CONNECTIONS FAMILY-CENTERED THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL PYSCHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:315-633-5253
Mailing Address - Street 1:1744 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-1902
Mailing Address - Country:US
Mailing Address - Phone:315-468-3414
Mailing Address - Fax:
Practice Address - Street 1:1744 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-1902
Practice Address - Country:US
Practice Address - Phone:315-468-3414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097-44-9325252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency