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NPI Code Detail

MEDICARE: ANIESKA LAVERGNE BT

MEDICARE:   ANIESKA  LAVERGNE  BT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1184551939
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANIESKA LAVERGNE BT
Provider Business Mailing Address
First Line : 209 W MAIN ST
Second Line :
City : CLINTON
State : NC
Zip : 28328-4048
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 209 W MAIN ST
Second Line :
City : CLINTON
State : NC
Zip : 28328-4048
Country : US
Telephone Number : 910-379-0443
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2026
Last Update Date : 05/06/2026

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Directions to “ ANIESKA LAVERGNE BT” Practice Location

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