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NPI Code Detail

MEDICARE: MS. VERGENA PEARL GAINEY RBT

MEDICARE: MS. VERGENA PEARL GAINEY RBT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1194481481
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VERGENA PEARL GAINEY RBT
Provider Business Mailing Address
First Line : 1711 CENTRAL AVE
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-9320
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1711 CENTRAL AVE
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-9320
Country : US
Telephone Number : 843-460-2605
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2021
Last Update Date : 09/02/2025

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