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General NPI Number Information
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NPI Number | 1831672575
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Entity Type | Organization
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Legal Business Name | EARLY OPPORTUNITIES WITH LANGUAGE AND SPEECH (EARLY O.W.L.S.)
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 4 CHASE VIEW RD
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City | FAIRPORT
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State | NY
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Zip | 14450-9700
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Country | US
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Telephone | 585-943-9871
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Fax |
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Provider Business Mailing Address
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Address Line | 4 CHASE VIEW RD
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City | FAIRPORT
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State | NY
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Zip | 14450-9700
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Country | US
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Telephone | 585-943-9871
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Fax |
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Authorized Official
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Title or Position | OWNER, SOLE PROPRIETOR
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Name | STEPHANIE DEENEY
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Credential | MA,CCC-SLP
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Telephone | 585-943-9871
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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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