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NPI Code Detail

MEDICARE: KASEY GERHART BCBA

MEDICARE: KASEY GERHART 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 : 1558727594
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASEY GERHART BCBA
Provider Business Mailing Address
First Line : 720 DALMORE DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28311-1133
Country : US
Telephone Number : 904-437-6791
Fax Number :
Provider Business Practice Location Address
First Line : 920 CAMBRIDGE ST
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28303-5300
Country : US
Telephone Number : 910-493-3555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2016
Last Update Date : 02/25/2021

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Directions to “ KASEY GERHART BCBA” Practice Location

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