NPI 1992046668

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Organisation Early Intervention Provider Agency Fayetteville, NC

Practice location

Address: 3419b Melrose Rd, Fayetteville, NC 28304-1608
Phone: (910) 257-2005
Fax: (910) 485-6315

Authorised official

Name: Tammy Rozier Autry
Title: Office Administrator
Phone: (910) 257-2005

Registered specialties

Early Intervention Provider Agency Primary

Agencies Taxonomy 252Y00000X Licence 6074 (NC)

Other Early Intervention Provider Agency providers in North Carolina →

Registry record

NPI: 1992046668
Entity type: Organization
NPI issued: 6 Mar 2013
Record last updated: 6 Mar 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.