Organization
IMPACT A.B.A. THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEPHANIE SHANELLE BARNES M.S., BCBA ,LBA (OWNER)
(919) 763-4653
Entity
Organization
Contact information
Practice address
3661 SUNSET AVE STE 353, ROCKY MOUNT, NC 27804-3411
(919) 763-4653
Mailing address
3661 SUNSET AVE STE 353, ROCKY MOUNT, NC 27804-3411
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
11/29/2018
Last updated
11/29/2018
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