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Organization
WOODBRIDGE AUTISM CENTER, PLLC
Active
Organization
WOODBRIDGE AUTISM CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHERINE SARAH DAVLANTIS PH.D., LCSW, BCBA (MANAGER/OWNER)
(919) 502-1450
Entity
Organization
Contact information
Practice address
101 GLENHIGH CT, CARY, NC 27511-5200
(919) 502-1450
Mailing address
2054 KILDAIRE FARM RD # 234, CARY, NC 27518-6614
(919) 502-1450
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-16-23002
NC
1041C0700X
Clinical Social Worker
Primary
C009279
NC
Other
Enumeration date
06/24/2017
Last updated
06/24/2017
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