Individual
ANTIONQUE COLETTE PENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 MACKENAN DR, CARY, NC 27511-7903
(919) 371-2848
Mailing address
111 MACKENAN DR, CARY, NC 27511-7903
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
NC
Other
Enumeration date
05/23/2019
Last updated
05/23/2019
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