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General NPI Number Information
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NPI Number | 1033812425
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Entity Type | Organization
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Legal Business Name | TINY WONDERS EARLY INTERVENTION SERVICES,LLP
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Dates
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Enumeration Date | 03/23/2023
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 416 SOUTHAMPTON DR
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City | IRMO
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State | SC
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Zip | 29063-9766
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Country | US
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Telephone | 803-908-5616
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Fax |
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Provider Business Mailing Address
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Address Line | 416 SOUTHAMPTON DR
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City | IRMO
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State | SC
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Zip | 29063-9766
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Country | US
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Telephone | 803-908-5616
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Fax |
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Authorized Official
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Title or Position | CO- OWNER
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Name | MS. KIMBERLY C DONALD
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Credential | CCC-SLP
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Telephone | 803-908-5616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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