Healthcare Provider Details

I. General information

NPI: 1417851460
Provider Name (Legal Business Name): ADANNAYA AHAM-IROETUGO BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 TALS ROCK WAY STE 3
CARY NC
27519-1919
US

IV. Provider business mailing address

305 OBERLIN RD UNIT 241
RALEIGH NC
27605-3169
US

V. Phone/Fax

Practice location:
  • Phone: 919-745-8892
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: