| Living Soul Of North Carolina Aba | |
|
4030 Wake Forest Rd Ste 349 Raleigh NC 27609-0010 | |
| (561) 536-5888 | |
| Not Available |
| Full Name | Living Soul Of North Carolina Aba |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4030 Wake Forest Rd Ste 349, Raleigh, North Carolina |
| Authorized Official Name and Position | Jocelyn Thomas (BILLER) |
| Authorized Official Contact | 2012410079 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Soul Of North Carolina Aba 4030 Wake Forest Rd Ste 349 Raleigh NC 27609-0010 Ph: () - | Living Soul Of North Carolina Aba 4030 Wake Forest Rd Ste 349 Raleigh NC 27609-0010 Ph: (561) 536-5888 |
| NPI Number | 1881483220 |
|---|---|
| Provider Enumeration Date | 05/02/2025 |
| Last Update Date | 05/02/2025 |
| Certification Date | 05/02/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881483220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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