Healthcare Provider Details

I. General information

NPI: 1831013226
Provider Name (Legal Business Name): VERNECIA MODESTE BT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 DOWD CIR STE A
PINEHURST NC
28374-7932
US

IV. Provider business mailing address

3433 TOWN ST APT H
HOPE MILLS NC
28348-8132
US

V. Phone/Fax

Practice location:
  • Phone: 910-295-2609
  • Fax:
Mailing address:
  • Phone: 910-303-4443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: