Provider Demographics
NPI:1255858841
Name:AVILEZ-YLLANES, BIANCA DO'CARMO
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:DO'CARMO
Last Name:AVILEZ-YLLANES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 DREAMCATCHER TRAIL
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27596
Mailing Address - Country:US
Mailing Address - Phone:919-985-9745
Mailing Address - Fax:
Practice Address - Street 1:315 DREAMCATCHER TRAIL
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27596
Practice Address - Country:US
Practice Address - Phone:919-985-9745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRBT-17-36351106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician