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General NPI Number Information
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NPI Number | 1679417216
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Entity Type | Organization
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Legal Business Name | DIVINE EARLY INTERVENTION SERVICES
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Dates
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Enumeration Date | 04/15/2026
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Last Update Date | 04/15/2026
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Provider Practice Location Address
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Address Line | 298 GREAT RD
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City | MAPLE SHADE
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State | NJ
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Zip | 08052-3045
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Country | US
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Telephone | 347-570-6310
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Fax | 347-570-6310
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Provider Business Mailing Address
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Address Line | 298 GREAT RD
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City | MAPLE SHADE
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State | NJ
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Zip | 08052-3045
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Country | US
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Telephone | 347-570-6310
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Fax | 347-570-6310
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Authorized Official
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Title or Position | OWNER
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Name | MERLINE DENIS
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Credential | DENIS
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Telephone | 347-570-6310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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