Healthcare Provider Details

I. General information

NPI: 1487117586
Provider Name (Legal Business Name): TYLER ROBBINS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5535 CURRITUCK DR STE 220
WILMINGTON NC
28403-1155
US

IV. Provider business mailing address

5535 CURRITUCK DR STE 220
WILMINGTON NC
28403-1155
US

V. Phone/Fax

Practice location:
  • Phone: 910-348-0186
  • Fax: 833-706-8600
Mailing address:
  • Phone: 910-251-8990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number3718
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: