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NPI Code Detail

MEDICARE: DEENA URSO

MEDICARE: DEENA URSO
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 : 1659980555
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEENA URSO
Provider Business Mailing Address
First Line : 8613 HORNWOOD CT
Second Line :
City : CHARLOTTE
State : NC
Zip : 28215-9313
Country : US
Telephone Number : 980-616-1192
Fax Number :
Provider Business Practice Location Address
First Line : 3000 LATROBE DR STE B
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-5227
Country : US
Telephone Number : 704-780-4271
Fax Number : 888-261-6694
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2020
Last Update Date : 07/27/2020

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Directions to “ DEENA URSO ” Practice Location

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