Provider Demographics
NPI:1194914150
Name:AUGMENTATIVE LEARNING AND MOVEMENT CENTER, LLC
Entity type:Organization
Organization Name:AUGMENTATIVE LEARNING AND MOVEMENT CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVOTNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-879-7177
Mailing Address - Street 1:35 WENTWORTH DR
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-9733
Mailing Address - Country:US
Mailing Address - Phone:802-879-7177
Mailing Address - Fax:802-879-0750
Practice Address - Street 1:35 WENTWORTH DR
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-9733
Practice Address - Country:US
Practice Address - Phone:802-879-7177
Practice Address - Fax:802-879-0750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Single Specialty