Healthcare Provider Details

I. General information

NPI: 1851150643
Provider Name (Legal Business Name): FAYE ASHLEY ATWOOD M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2024
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 BUSH ST
RALEIGH NC
27609-7511
US

IV. Provider business mailing address

PO BOX 749
BELMONT NC
28012-0749
US

V. Phone/Fax

Practice location:
  • Phone: 252-269-8264
  • Fax:
Mailing address:
  • Phone: 704-869-2088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberA2770
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number4348
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: