Healthcare Provider Details

I. General information

NPI: 1508474149
Provider Name (Legal Business Name): APEKE ALATISE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2020
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 W LEXINGTON AVE
HIGH POINT NC
27262-2533
US

IV. Provider business mailing address

219 W LEXINGTON AVE
HIGH POINT NC
27262-2533
US

V. Phone/Fax

Practice location:
  • Phone: 440-317-4676
  • Fax:
Mailing address:
  • Phone: 440-317-4676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number569619
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: