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NPI Code Detail

MEDICARE: HOLLY RAYE WELCH RBT

MEDICARE: HOLLY RAYE WELCH 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 TechnicianBACB685167NC

General Provider Information

NPI Number : 1568174076
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY RAYE WELCH RBT
Provider Business Mailing Address
First Line : 1338 CHERRY DR
Second Line :
City : BURLINGTON
State : NC
Zip : 27215-3306
Country : US
Telephone Number : 336-214-9117
Fax Number :
Provider Business Practice Location Address
First Line : 5101 DUNLEA CT STE 201C
Second Line :
City : WILMINGTON
State : NC
Zip : 28405-4436
Country : US
Telephone Number : 910-390-6621
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2022
Last Update Date : 12/15/2022

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Directions to “ HOLLY RAYE WELCH RBT” Practice Location

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