=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902729429
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE EARLY INTERVENTION PLAY STUDIO LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2026
-----------------------------------------------------
Last Update Date | 08/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 53 DARBY RD STE U
-----------------------------------------------------
City | PAOLI
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19301-1472
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-306-7496
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7 W GOLF CLUB LN
-----------------------------------------------------
City | PAOLI
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19301-1536
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-306-7496
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BEHAVIOR ANALYST
-----------------------------------------------------
Name | MS. HILLARY GRAY
-----------------------------------------------------
Credential | MS ABA, LBS
-----------------------------------------------------
Telephone | 610-306-7496
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------