Organization
SOUTH BRANCH BEHAVIORAL HEALTH & EDUCATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEN DICOB (ADMINISTRATOR)
(919) 802-6202
Entity
Organization
Contact information
Practice address
241 OLD GROVE LN, APEX, NC 27502-7005
(919) 802-6202
Mailing address
241 OLD GROVE LN, APEX, NC 27502-7005
(919) 802-6202
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/30/2023
Last updated
03/30/2023
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