Healthcare Provider Details

I. General information

NPI: 1831014919
Provider Name (Legal Business Name): SAMANTHA LORRAINE FEIGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MACKENAN DR
CARY NC
27511-6498
US

IV. Provider business mailing address

104 STORM CT
CARY NC
27513-4153
US

V. Phone/Fax

Practice location:
  • Phone: 984-484-0823
  • Fax:
Mailing address:
  • Phone: 984-484-0823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: