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General NPI Number Information
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NPI Number | 1528971629
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Entity Type | Individual
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Provider Name | DESIREE' NYANNA HEARD
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Gender | Female
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 2800 MERIDIAN PKWY STE 100
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City | DURHAM
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State | NC
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Zip | 27713-1798
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Country | US
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Telephone | 984-209-5942
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 E CORNWALLIS RD APT 634
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City | DURHAM
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State | NC
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Zip | 27713-3459
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Country | US
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Telephone | 470-661-4123
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-26-2843919
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License Number State | NC
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