Healthcare Provider Details

I. General information

NPI: 1194485714
Provider Name (Legal Business Name): ROSA STRONG BEHAVIOR ANALYST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2021
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 7 LAKES DR
WEST END NC
27376-9082
US

IV. Provider business mailing address

195 W ILLINOIS AVE
SOUTHERN PINES NC
28387-5808
US

V. Phone/Fax

Practice location:
  • Phone: 910-673-5437
  • Fax: 910-673-5438
Mailing address:
  • Phone: 910-673-5437
  • Fax: 910-673-5438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number3110
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: