Individual
MYTHILI REVATHI LOKESHWARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2329 E WT HARRIS BLVD, CHARLOTTE, NC 28213
(704) 529-9090
Mailing address
74 CUMBERLAND CT SW, CONCORD, NC 28025-5823
(910) 600-2433
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
A1106
NC
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/13/2020
Last updated
07/31/2024
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