Healthcare Provider Details

I. General information

NPI: 1952264509
Provider Name (Legal Business Name): AMY E BRUMMITT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7980 CHAPEL HILL RD STE 135
CARY NC
27513-4649
US

IV. Provider business mailing address

7334 CHAPEL HILL RD
RALEIGH NC
27607-5099
US

V. Phone/Fax

Practice location:
  • Phone: 919-377-2399
  • Fax:
Mailing address:
  • Phone: 919-377-2399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-487313
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: