Individual
AUTUMN SAGE TABORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3610 BUSH ST, RALEIGH, NC 27609-7511
(984) 204-1233
Mailing address
3509 LYDFORD PL, GARNER, NC 27529-7240
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/08/2025
Last updated
07/08/2025
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