Individual
BOPHA THEANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 BELGIAN DR, LEXINGTON, NC 27295-6283
(336) 425-7860
(336) 425-7860
Mailing address
202 BELGIAN DR, LEXINGTON, NC 27295-6283
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-425042
NC
Other
Enumeration date
07/15/2026
Last updated
07/15/2026
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