Provider Demographics
NPI:1306142278
Name:D. EARLY, PH.D., INC.
Entity type:Organization
Organization Name:D. EARLY, PH.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:EARLY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:314-894-2900
Mailing Address - Street 1:6220 S LINDBERGH BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-7839
Mailing Address - Country:US
Mailing Address - Phone:314-894-2900
Mailing Address - Fax:314-894-2960
Practice Address - Street 1:6220 S LINDBERGH BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-7839
Practice Address - Country:US
Practice Address - Phone:314-894-2900
Practice Address - Fax:314-894-2960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006028096261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1649347329OtherNPIN AS AN INDIVIDUAL PROVIDER
MO11798822OtherCAQH
MO1649347329OtherNPIN AS AN INDIVIDUAL PROVIDER