Provider Demographics
NPI:1689385155
Name:ARMSTRONG, EMILY ROSE (BT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ROSE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:BT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8117 EBENEZER CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-7307
Mailing Address - Country:US
Mailing Address - Phone:984-263-0654
Mailing Address - Fax:
Practice Address - Street 1:8117 EBENEZER CHURCH RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-7307
Practice Address - Country:US
Practice Address - Phone:984-263-0654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician