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General NPI Number Information
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NPI Number | 1821334491
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Entity Type | Organization
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Legal Business Name | CUTTING EDGE DEVELOPMENTAL THERAPIES, LLC
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Dates
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Enumeration Date | 12/29/2012
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Last Update Date | 12/29/2012
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Provider Practice Location Address
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Address Line | 1008 HEGLAR ST
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City | CHINA GROVE
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State | NC
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Zip | 28023-2612
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Country | US
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Telephone | 704-857-6625
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Fax |
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Provider Business Mailing Address
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Address Line | 1008 HEGLAR ST
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City | CHINA GROVE
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State | NC
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Zip | 28023-2612
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Country | US
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Telephone | 704-857-6625
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. NORMA W HONEYCUTT
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Credential |
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Telephone | 704-857-6625
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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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