Individual
CLEO READY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3735 ADMIRAL DR STE 101, HIGH POINT, NC 27265-1567
(336) 885-9367
(336) 885-9857
Mailing address
3735 ADMIRAL DR STE 101, HIGH POINT, NC 27265-1567
(336) 885-9367
(336) 885-9857
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-19705
CO
103K00000X
Behavior Analyst
Primary
1-15-19705
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019713500
—
FL
Enumeration date
02/18/2016
Last updated
07/22/2026
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