Healthcare Provider Details

I. General information

NPI: 1134486053
Provider Name (Legal Business Name): HONEY BEARS EARLY INTERVENTION COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2012
Last Update Date: 06/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 ELKINS AVE
ELKINS PARK PA
19027-1204
US

IV. Provider business mailing address

830 ELKINS AVE
ELKINS PARK PA
19027-1204
US

V. Phone/Fax

Practice location:
  • Phone: 267-252-7610
  • Fax:
Mailing address:
  • Phone: 267-252-7610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT018043
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberPT018043
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberPT018043
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ANDREA A PITTS
Title or Position: PHYSICAL THERAPIST
Credential: DPT,CLT,ATC
Phone: 267-252-7610