Organization Name: | EARLY AUTISM PROJECT, INC. |
NPI Number: | 1003156928 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN BUTLER (CEO) |
Mailing Address: | 2580 Lin Do Ct Sumter |
State: | SC US |
Postal Code: | 291501832 |
Phone Number: | 8039054427 |
Fax Number: | 8039054431 |
NPI Enumeration Date: | 03/01/2013 |
NPI Last Update Date: | 03/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | 1239 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |