Provider Demographics
NPI:1528114261
Name:EARLY LEARNING COLLABORATIVE
Entity type:Organization
Organization Name:EARLY LEARNING COLLABORATIVE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:G
Authorized Official - Last Name:WAINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR,L
Authorized Official - Phone:407-629-9455
Mailing Address - Street 1:1016 SPRING VILLAS POINTE
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708
Mailing Address - Country:US
Mailing Address - Phone:407-629-9455
Mailing Address - Fax:407-629-9138
Practice Address - Street 1:1016 SPRING VILLAS POINTE
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708
Practice Address - Country:US
Practice Address - Phone:407-629-9455
Practice Address - Fax:407-629-9138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLX1250OtherBCBS