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Individual

DYLAN AVERY FARNSWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
913 E ARLINGTON BLVD, GREENVILLE, NC 27858-5864
(252) 999-8559
Mailing address
1507 ROUGH RIDER LN, PARKTON, NC 28371-7719
(910) 494-1296

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
02/15/2024
Last updated
02/15/2024
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