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General NPI Number Information
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NPI Number | 1205347101
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Entity Type | Organization
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Legal Business Name | EARLY INTERVENTION SOLUTIONS LLC
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Dates
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Enumeration Date | 10/18/2017
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Last Update Date | 10/18/2017
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Provider Practice Location Address
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Address Line | 4022 LAND O LAKES BLVD
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City | LAND O LAKES
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State | FL
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Zip | 34639-4413
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Country | US
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Telephone | 813-335-1173
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Fax | 813-996-9691
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Provider Business Mailing Address
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Address Line | 22214 SHORESIDE DR
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City | LAND O LAKES
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State | FL
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Zip | 34639-4615
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Country | US
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Telephone | 813-335-1173
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Fax | 813-996-9691
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Authorized Official
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Title or Position | FOUNDER
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Name | COURTNEY WHITAKER
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Credential |
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Telephone | 813-335-1173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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