Organization
PROFESSIONAL EARLY INTERVENTION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA M CARROLL M.ED (OWNER)
(910) 425-6282
Entity
Organization
Contact information
Practice address
2722 FORT BRAGG RD, FAYETTEVILLE, NC 28303-4721
(910) 425-6282
(910) 425-6554
Mailing address
1708A OWEN DR, FAYETTEVILLE, NC 28304-3419
(910) 425-6282
(910) 425-6554
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
02/08/2007
Last updated
04/01/2022
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