Individual
KYLIE DEANNE EDGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 MILITARY CUTOFF RD, WILMINGTON, NC 28405-9737
(910) 465-9120
Mailing address
408 BRUNSWICK ST, WILMINGTON, NC 28401-3439
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
RBT-17-40934
NC
Other
Enumeration date
10/19/2017
Last updated
10/19/2017
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