Organization
EARLY ADVANTAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA BATTEN REAGAN MS, OTR L (OWNER,THERAPIST)
(843) 270-3567
Entity
Organization
Contact information
Practice address
1320 EDEN RD, AWENDAW, SC 29429-5914
(843) 270-3567
(843) 856-4932
Mailing address
1320 EDEN RD, AWENDAW, SC 29429-5914
(843) 270-3567
(843) 856-4932
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1498
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4022
—
SC
05
—
TH1465
—
SC
Enumeration date
12/28/2006
Last updated
11/19/2013
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