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General NPI Number Information
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NPI Number | 1447027818
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Entity Type | Organization
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Legal Business Name | A DIVINE BEGINNING, LLC
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Dates
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Enumeration Date | 12/06/2023
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 2817 EDGEWOOD AVE
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City | COLUMBIA
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State | SC
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Zip | 29204-2122
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Country | US
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Telephone | 803-238-4115
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Fax | 843-799-1674
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Provider Business Mailing Address
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Address Line | 2817 EDGEWOOD AVE
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City | COLUMBIA
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State | SC
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Zip | 29204-2122
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Country | US
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Telephone | 803-238-4115
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Fax | 843-799-1674
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Authorized Official
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Title or Position | CO-OWNER/ OPERATOR
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Name | MITOYA WILLIAMS
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Credential |
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Telephone | 803-238-4115
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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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