Healthcare Provider Details

I. General information

NPI: 1902729429
Provider Name (Legal Business Name): THE EARLY INTERVENTION PLAY STUDIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 DARBY RD STE U
PAOLI PA
19301-1472
US

IV. Provider business mailing address

7 W GOLF CLUB LN
PAOLI PA
19301-1536
US

V. Phone/Fax

Practice location:
  • Phone: 610-306-7496
  • Fax:
Mailing address:
  • Phone: 610-306-7496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MS. HILLARY GRAY
Title or Position: BEHAVIOR ANALYST
Credential: MS ABA, LBS
Phone: 610-306-7496