# EARLY INTERVENTION SPECIALIST

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

## Provider details

- **NPI number:** 1780084673
- **Authorized official:** SHAUNDELL MARCIA DAVIS-THOMAS MSED (SPECIAL EDUCATION TEACHER)
- **Authorized official phone:** (917) 583-4937

## Contact information

- **Practice address:** 543 MAIN ST APT 414, NEW ROCHELLE, NY 10801-7265
- **Practice address phone:** (917) 583-4937
- **Mailing address:** 543 MAIN ST APT 414, NEW ROCHELLE, NY 10801-7265
- **Mailing address phone:** (917) 583-4937

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 689745 | NY | Yes |

## Other

- **Enumeration date:** 08/27/2014
- **Last updated:** 08/27/2014