Organization
EARLY INTERVENTION SPECIALISTS OF NORTHWEST FLORIDA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIA S THOMPSON RN (OWNER)
(850) 209-5880
Entity
Organization
Contact information
Practice address
5170 12TH AVE, MALONE, FL 32445-3426
(850) 209-5880
(866) 521-4620
Mailing address
5170 12TH AVE, MALONE, FL 32445-3426
(850) 209-5880
(866) 521-4620
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
RN3076242
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
810941900
—
FL
Enumeration date
03/07/2013
Last updated
03/07/2013
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