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General NPI Number Information
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NPI Number | 1609236165
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Entity Type | Organization
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Legal Business Name | DREAMWORKS THERAPEUTIC LEARNING CENTER
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Dates
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Enumeration Date | 02/26/2016
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Last Update Date | 02/26/2016
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Provider Practice Location Address
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Address Line | 207 C SOUTH POPLAR ST
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City | ELIZABETHTOWN
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State | NC
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Zip | 28337
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Country | US
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Telephone | 910-874-8130
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1446
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City | ELIZABETHTOWN
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State | NC
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Zip | 28337-1446
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Country | US
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Telephone | 910-874-8130
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHAYLA J YANCEY
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Credential |
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Telephone | 910-874-8130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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