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General NPI Number Information
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NPI Number | 1447377288
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Entity Type | Organization
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Legal Business Name | EARLY INTERVENTION ASSOCIATES, LLC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 3204 TOWER OAKS BLVD. SUITE 150
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City | ROCKVILLE
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State | MD
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Zip | 20852
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Country | US
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Telephone | 301-468-9343
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Fax | 301-230-2127
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Provider Business Mailing Address
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Address Line | 3204 TOWER OAKS BLVD SUITE 150
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City | ROCKVILLE
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State | MD
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Zip | 20852
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Country | US
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Telephone | 301-468-9343
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Fax | 301-230-2127
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | TRISTANN DB LEE
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Credential | PT DPT
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Telephone | 301-468-9343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 15297
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License Number State | MD
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