| Total Intervention Early Services (ties) | |
|
4699 N State Road 7 Suite P Lauderdale Lakes FL 33319-5879 | |
| (954) 234-2724 | |
| (954) 302-1830 |
| Full Name | Total Intervention Early Services (ties) |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4699 N State Road 7, Lauderdale Lakes, Florida |
| Authorized Official Name and Position | Paula N Locke (LICENSE CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 7542040312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Total Intervention Early Services (ties) 9470 Live Oak Pl Suite 405 Davie FL 33324-4769 Ph: (754) 204-0312 | Total Intervention Early Services (ties) 4699 N State Road 7 Suite P Lauderdale Lakes FL 33319-5879 Ph: (954) 234-2724 |
| NPI Number | 1245469303 |
|---|---|
| Provider Enumeration Date | 07/10/2009 |
| Last Update Date | 05/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245469303 | NPI | - | NPPES |
| 001314200 | Medicaid | FL | |
| 761451900 | Medicaid | FL | |
| 002968700 | Medicaid | FL | |
| 001867700 | Medicaid | FL | |
| DJ386A | Other | FL | MEDICARE PTAN |
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