Provider Demographics
NPI:1619274685
Name:EARLY START THERAPY
Entity Type:Organization
Organization Name:EARLY START THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:BOLANLE
Authorized Official - Last Name:AKINYELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-254-0782
Mailing Address - Street 1:2445 ARMY NAVY DR
Mailing Address - Street 2:SUITE 305
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2905
Mailing Address - Country:US
Mailing Address - Phone:703-813-6330
Mailing Address - Fax:301-710-6379
Practice Address - Street 1:6416 GROVEDALE DR STE 300
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-2678
Practice Address - Country:US
Practice Address - Phone:703-813-6330
Practice Address - Fax:301-710-6379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD037761900Medicaid
VA1619274685Medicaid