Healthcare Provider Details

I. General information

NPI: 1164724191
Provider Name (Legal Business Name): PATRICIA HUSKEY BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2010
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 PARK RIDGE LN APT F
WINSTON SALEM NC
27104-5602
US

IV. Provider business mailing address

410 PARK RIDGE LN APT F
WINSTON SALEM NC
27104-5602
US

V. Phone/Fax

Practice location:
  • Phone: 732-703-2060
  • Fax:
Mailing address:
  • Phone: 732-703-2060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-07-3746
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: