MEDICARE: MRS. HOLLY ANGELIQUE YORK 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
1	103K00000X	Behavior Analyst	1-08-4659	LA
2	103K00000X	Behavior Analyst	4426	NC

General Provider Information

NPI Number	:	1952548380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HOLLY ANGELIQUE YORK BCBA

Provider Business Mailing Address
First Line	:	PO BOX 749
Second Line	:
City	:	BELMONT
State	:	NC
Zip	:	28012-0749
Country	:	US
Telephone Number	:	704-869-2088
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 MARKET ST STE 200
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-4493
Country	:	US
Telephone Number	:	984-528-8787
Fax Number	:	984-246-1223

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2009
Last Update Date	:	06/09/2026

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