Healthcare Provider Details

I. General information

NPI: 1134877426
Provider Name (Legal Business Name): ALICE TOUKOLON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2022
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 RDU CENTER DR STE 135
MORRISVILLE NC
27560-7687
US

IV. Provider business mailing address

3036 BRISTOL CREEK DR APT 302
MORRISVILLE NC
27560-7870
US

V. Phone/Fax

Practice location:
  • Phone: 984-330-7468
  • Fax:
Mailing address:
  • Phone: 301-765-4948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2848817
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-22-202530
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: