Healthcare Provider Details

I. General information

NPI: 1255278594
Provider Name (Legal Business Name): ASHANTI ROYALL
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7334 CHAPEL HILL RD
RALEIGH NC
27607-5099
US

IV. Provider business mailing address

7980 CHAPEL HILL RD STE 135
CARY NC
27513-4649
US

V. Phone/Fax

Practice location:
  • Phone: 919-377-2399
  • Fax: 919-800-3925
Mailing address:
  • Phone: 919-377-2399
  • Fax: 919-800-3925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-426119
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: