# SMALL WONDERS EARLY INTERVENTION SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124279757
- **Authorized official:** MR. DOUGLAS VAUGHN WASHBURN M. ED. (PRESIDENT)
- **Authorized official phone:** (607) 798-8056

## Contact information

- **Practice address:** 1364 REYNOLDS RD, JOHNSON CITY, NY 13790-4837
- **Practice address phone:** (607) 584-0709
- **Practice address fax:** (607) 770-1446
- **Mailing address:** 1364 REYNOLDS RD, JOHNSON CITY, NY 13790-4837
- **Mailing address phone:** (607) 584-0709
- **Mailing address fax:** (607) 770-1446

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/01/2008
- **Last updated:** 09/27/2010