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General NPI Number Information
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NPI Number | 1346577194
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Entity Type | Organization
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Legal Business Name | TEES COMPANY
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Dates
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Enumeration Date | 11/13/2009
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Last Update Date | 11/13/2009
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Provider Practice Location Address
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Address Line | 1908 CEDAR POINT CIR
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-9695
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Country | US
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Telephone | 252-340-6473
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Fax |
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Provider Business Mailing Address
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Address Line | 1908 CEDAR POINT CIR
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-9695
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OWNER
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Name | MRS. TERRICA NICHELLE MITCHELL
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Credential | B A
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Telephone | 252-340-6473
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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 | C200923800027
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License Number State | NC
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