Healthcare Provider Details
I. General information
NPI: 1902733538
Provider Name (Legal Business Name): WHOLE CHILD ALLIANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4600 BAINVIEW DR
MINT HILL NC
28227-9797
US
IV. Provider business mailing address
11300 LAWYERS RD STE J
MINT HILL NC
28227-9334
US
V. Phone/Fax
- Phone: 704-368-2570
- Fax: 704-312-9217
- Phone: 704-368-2570
- Fax: 704-312-9217
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
TYLER
LAWRENCE
Title or Position: BCBA/PRACTICE OWNER
Credential: BCBA
Phone: 704-920-9691