Healthcare Provider Details

I. General information

NPI: 1750061248
Provider Name (Legal Business Name): DION YELDER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6634 OLD STATESVILLE RD
CHARLOTTE NC
28269-6768
US

IV. Provider business mailing address

5801 TRIANGLE OAKS DR
RALEIGH NC
27616-4833
US

V. Phone/Fax

Practice location:
  • Phone: 877-262-2221
  • Fax: 877-745-4345
Mailing address:
  • Phone: 804-773-5091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number4814
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: