| Organization Name: | CHILDHOOD AUTISM THERAPIES LLC |
| NPI Number: | 1144551664 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | COLLEEN A RYAN (DIRECTOR) |
| Mailing Address: | N1563 County Road H Palmyra |
| State: | WI US |
| Postal Code: | 531569738 |
| Phone Number: | 2623705527 |
| Fax Number: | 2624958689 |
| NPI Enumeration Date: | 01/22/2010 |
| NPI Last Update Date: | 01/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 2387-57 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |