Individual
LISA WITHROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2919 BREEZEWOOD AVE STE 101, FAYETTEVILLE, NC 28303-5283
(910) 484-1711
Mailing address
2919 BREEZEWOOD AVE STE 101, FAYETTEVILLE, NC 28303-5283
(910) 484-1711
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2151
NC
106S00000X
Behavior Technician
RBT-19-84076
NC
Other
Enumeration date
06/09/2021
Last updated
11/20/2024
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