Healthcare Provider Details

I. General information

NPI: 1487593489
Provider Name (Legal Business Name): EDEN ROSE WILLIAMSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1641 MATTHEWS TOWNSHIP PKWY
MATTHEWS NC
28105-5927
US

IV. Provider business mailing address

4000 SACAR WAY SUITE 410
DURHAM NC
27709
US

V. Phone/Fax

Practice location:
  • Phone: 980-374-3984
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: