Provider Demographics
NPI:1124661152
Name:CONNECTED COGNITION LLC
Entity type:Organization
Organization Name:CONNECTED COGNITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:MIGLIORINI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-288-5141
Mailing Address - Street 1:1345 NW WALL ST STE 303
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-1970
Mailing Address - Country:US
Mailing Address - Phone:781-288-5141
Mailing Address - Fax:541-797-6471
Practice Address - Street 1:1345 NW WALL ST STE 303
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-1970
Practice Address - Country:US
Practice Address - Phone:781-288-5141
Practice Address - Fax:541-797-6471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-22
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty