Healthcare Provider Details

I. General information

NPI: 1093651093
Provider Name (Legal Business Name): LYNDA N LAVOIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710A JOHN PLATT DR
MOREHEAD CITY NC
28557-4372
US

IV. Provider business mailing address

203 MONTEREY CIR
NEW BERN NC
28562-4269
US

V. Phone/Fax

Practice location:
  • Phone: 252-777-3140
  • Fax:
Mailing address:
  • Phone: 252-349-1567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-305863
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: