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Organization

LIFESPAN ABA INC.

Active
Other names
Lifespan Behavioral & Consultation Services
Organization subpart
No

Provider details

NPI number
Authorized official
MISS SHARONDA FERGUSON (BCBA/CLINICAL DIRECTOR)
(910) 493-3999
Entity
Organization

Contact information

Practice address
351 WAGONER DRIVE, SUITE 350, FAYETTEVILLE, NC 28303
(910) 493-3999
(910) 728-4644
Mailing address
351 WAGONER DRIVE, SUITE 350, FAYETTEVILLE, NC 28303
(910) 493-3999
(910) 728-4644

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
1-12-12589
NC
251S00000X
Community/Behavioral Health Agency
Primary
1-12-12589

Other

Enumeration date
04/22/2013
Last updated
04/07/2014
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