NPI 1922277417 · live from the CMS NPI Registry
Abc Of Nc Child Development Center
Early Intervention Provider Agency in Winston Salem, NC. National Provider Identifier 1922277417, active.
NPI record
| NPI | 1922277417 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Early Intervention Provider Agency 252Y00000X |
| Practice location | 905 Friedberg Church Rd, Winston Salem, NC 27127 |
| Practice phone | 336-251-1180 |
| Enumerated | February 28, 2008 |
| Last updated | June 21, 2023 |
| Authorized official | Selene Johnson, Executive Director |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical | 103TC0700X | 4074 (NC) |
| Behavior Analyst | 103K00000X | 1084186 |
| Behavior Analyst | 103K00000X | 122977 |
| Behavior Analyst | 103K00000X | 0125034 |
| Early Intervention Provider Agency primary | 252Y00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.