Individual
ADELLE ANNA OVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10926 S TRYON ST, CHARLOTTE, NC 28273
(855) 201-5498
Mailing address
10926 S TRYON ST, CHARLOTTE, NC 28273-4153
(855) 201-5498
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
488699
NC
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
488699
BCBA ID
NC
Enumeration date
01/18/2019
Last updated
06/27/2019
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