Healthcare Provider Details

I. General information

NPI: 1235052911
Provider Name (Legal Business Name): EARLY START AUTISM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7778 SW JACK JAMES DR
STUART FL
34997-7249
US

IV. Provider business mailing address

11718 SE FEDERAL HWY # 245
HOBE SOUND FL
33455-5303
US

V. Phone/Fax

Practice location:
  • Phone: 561-377-0009
  • Fax:
Mailing address:
  • Phone: 504-669-9099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER DODGE
Title or Position: RBT
Credential:
Phone: 347-623-2486