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General NPI Number Information
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NPI Number | 1841437837
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Entity Type | Organization
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Legal Business Name | WESTERN NORTH CAROLINA BEHAVIORAL EDUCATION, SERVICES & TREATMENT,P.A.
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 01/13/2009
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Provider Practice Location Address
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Address Line | 13 BRUCEMONT CIR
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City | ASHEVILLE
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State | NC
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Zip | 28806-3402
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Country | US
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Telephone | 828-778-2378
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Fax | 828-350-1916
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Provider Business Mailing Address
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Address Line | PO BOX 6008
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City | ASHEVILLE
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State | NC
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Zip | 28816-6008
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Country | US
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Telephone | 828-778-2378
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Fax | 828-350-1916
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. VIRGINIA CAROLINE MINICOZZI
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Credential | SLP/CCC, BCBA
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Telephone | 828-778-2378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 6274
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License Number State | NC
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