Healthcare Provider Details

I. General information

NPI: 1760386874
Provider Name (Legal Business Name): ALICIA RAYE BARNETTE
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

2889 ISLAND POINT DR NW
CONCORD NC
28027-2537
US

IV. Provider business mailing address

2889 ISLAND POINT DR NW
CONCORD NC
28027-2537
US

V. Phone/Fax

Practice location:
  • Phone: 704-956-8657
  • Fax:
Mailing address:
  • Phone: 704-956-8657
  • Fax: 704-956-8657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: