# INNER GLOW EARLY INTERVENTION LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Patricia V Lawrence, Inner Glow Early Intervention LLC, Early Intervention/Special Instruction, Patricia V Lawrence
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508691551
- **Authorized official:** MS. PATRICIA V LAWRENCE SPECIAL ED TEACHER (SPECIAL INSTRUCTOR)
- **Authorized official phone:** (929) 434-7076

## Contact information

- **Practice address:** 140 MIRIN AVE, ROOSEVELT, NY 11575-1624
- **Practice address phone:** (929) 434-7076
- **Practice address fax:** (516) 442-5105
- **Mailing address:** 140 MIRIN AVE, ROOSEVELT, NY 11575-1624
- **Mailing address phone:** (929) 434-7076
- **Mailing address fax:** (516) 442-5105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/07/2024
- **Last updated:** 09/07/2024