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NPI Code Detail

MEDICARE: SAMANTHA AYRES BCBA

MEDICARE:   SAMANTHA  AYRES  BCBA
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1366093023
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA AYRES BCBA
Provider Business Mailing Address
First Line : 7022 SARDIS RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28270-6058
Country : US
Telephone Number : 704-366-8260
Fax Number :
Provider Business Practice Location Address
First Line : 7022 SARDIS RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28270-6058
Country : US
Telephone Number : 704-366-8260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2019
Last Update Date : 05/09/2024

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Directions to “ SAMANTHA AYRES BCBA” Practice Location

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