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General NPI Number Information
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NPI Number | 1932154408
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL ASSOCIATES OF ASHEBORO
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 547 N. FAYETTEVILLIE STREET
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City | ASHEBORO
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State | NC
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Zip | 27205
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Country | US
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Telephone | 336-629-7112
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Fax | 336-629-0312
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Provider Business Mailing Address
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Address Line | 547 N. FAYETTEVILLIE STREET
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City | ASHEBORO
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State | NC
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Zip | 27204
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Country | US
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Telephone | 336-629-7112
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Fax | 336-629-0312
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | WANDA L DANIEL
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Credential |
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Telephone | 336-629-7112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0078
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License Number State | NC
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