MEDICARE: TANEHA EASON

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1407705882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANEHA EASON

Provider Business Mailing Address
First Line	:	747 CRICKETWOOD LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-2155
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3070 SENNA DR
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-6726
Country	:	US
Telephone Number	:	855-201-5498
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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Directions to “ TANEHA EASON ” Practice Location

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