Healthcare Provider Details

I. General information

NPI: 1720929250
Provider Name (Legal Business Name): ETHAN LOUIS ROWLES-NACCARATO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4819 EMPEROR BLVD STE 400
DURHAM NC
27703-5420
US

IV. Provider business mailing address

1303 ENGLISH COTTAGE LN
CARY NC
27518-8731
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax:
Mailing address:
  • Phone: 845-443-9594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: