Organization
PROFESSIONAL EARLY INTERVENTION SERVICES, LLC
Active
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
1708A OWEN DR, FAYETTEVILLE, NC 28304-3419
(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
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
10/23/2006
Last updated
04/01/2022
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