Organization
EARLY BIRD DEVELOPMENTAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY SEITLIN KORNFELD MED, CCC-SLP (MEMBER/MANAGER)
(704) 995-2900
Entity
Organization
Contact information
Practice address
212 W MATTHEWS ST, SUITE 105, MATTHEWS, NC 28105-5441
(704) 846-0262
Mailing address
3007 SIMMON TREE RD, CHARLOTTE, NC 28270-0676
(704) 995-2900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
222Q00000X
Developmental Therapist
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7212110
—
NC
05
—
8302333
—
NC
Enumeration date
11/18/2006
Last updated
06/04/2013
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