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NPI Code Detail

MEDICARE: DENISE VERONICA FREEMAN DECANDIA BCBA

MEDICARE: DENISE VERONICA FREEMAN DECANDIA BCBA
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
1251S00000XCommunity/Behavioral Health Agency
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1386706661
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE VERONICA FREEMAN DECANDIA BCBA
Provider Business Mailing Address
First Line : 111 MACKENAN DR
Second Line :
City : CARY
State : NC
Zip : 27511-7903
Country : US
Telephone Number : 919-434-9319
Fax Number :
Provider Business Practice Location Address
First Line : 111 MACKENAN DR
Second Line :
City : CARY
State : NC
Zip : 27511-7903
Country : US
Telephone Number : 919-434-9319
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 03/05/2020

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Directions to “ DENISE VERONICA FREEMAN DECANDIA BCBA” Practice Location

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