Tara M Poulos

Individual provider Active NPI Behavior Technician · Cramerton, NC

NPI 1376209692 · NPPES record last updated Nov 10, 2021

Key facts

NPI
1376209692
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-18-48740 (NC)
Practice address
155 8TH Ave
Cramerton, NC 28032-1401
Phone
(980) 295-3431
NPI assigned
Nov 10, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-18-48740NCMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-18-48740 NC Yes

Addresses

Primary practice location

155 8TH Ave
Cramerton, NC 28032-1401

Mailing address

155 8TH Ave
Cramerton, NC 28032-1401
Phone (980) 295-3431

Other providers in Cramerton, NC

All providers in Cramerton, NC · Behavior Technician in North Carolina

Sources for this page

Verify at the official NPI Registry.