Healthcare Provider Details
I. General information
NPI: 1235905423
Provider Name (Legal Business Name): DREAM BUILDERS ABA NC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/28/2023
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3600 N DUKE ST
DURHAM NC
27704-1709
US
IV. Provider business mailing address
3600 N DUKE ST STE 1
DURHAM NC
27704-1769
US
V. Phone/Fax
- Phone: 732-228-3532
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHAYA
MAYER
Title or Position: PARTNER
Credential:
Phone: 732-228-3532