MEDICARE: KYNDRA LAWSON

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	103K00000X	Behavior Analyst
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1972093144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYNDRA LAWSON

Provider Business Mailing Address
First Line	:	455 SPENCERS GATE DR
Second Line	:
City	:	YOUNGSVILLE
State	:	NC
Zip	:	27596-7045
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5121 KINGDOM WAY, SUITE 100
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607
Country	:	US
Telephone Number	:	919-793-5362
Fax Number	:

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

Provider Enumeration Date	:	05/14/2018
Last Update Date	:	05/26/2026

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Directions to “ KYNDRA LAWSON ” Practice Location

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