| NPI | 1538383138 |
|---|---|
| Other Name | PEID |
| Entity Type | Organization |
| Authorized Contact | RENDA DUBOSE Credentialing Coordinator 540-373-3223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2024-08-15 |