Healthcare Provider Details

I. General information

NPI: 1396104360
Provider Name (Legal Business Name): CLEO READY BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CLEO CERVEIRA

II. Dates (important events)

Enumeration Date: 02/18/2016
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3735 ADMIRAL DR STE 101
HIGH POINT NC
27265-1567
US

IV. Provider business mailing address

3735 ADMIRAL DR STE 101
HIGH POINT NC
27265-1567
US

V. Phone/Fax

Practice location:
  • Phone: 336-885-9367
  • Fax: 336-885-9857
Mailing address:
  • Phone: 336-885-9367
  • Fax: 336-885-9857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-15-19705
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: