Super Kids Club LLC

NPI #1134396880 in Ridgefield, Connecticut

Provider Information

NPI Number: 1134396880
Entity Type: Organization
Organization Name: Super Kids Club LLC
Primary Specialty: Counselor
Enumeration Date: May 13, 2008
Last Updated: May 13, 2008

Practice Location

Address: 898 ETHAN ALLEN HWY
Address 2: SUITE 2
City: Ridgefield
State: Connecticut
ZIP Code: 06877-2813
Phone: (203) 431-9150

Authorized Official

Name: MS. NANCY WIDDOWS, LPC
Title: DIRECTOR
Phone: (203) 431-9150

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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