Provider Demographics
NPI:1295452951
Name:PATTERSON, CAROLYN GURGANUS (RBT)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:GURGANUS
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:BROOKE
Other - Last Name:GURGANUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 SPINNAKER ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-6681
Mailing Address - Country:US
Mailing Address - Phone:252-331-9333
Mailing Address - Fax:
Practice Address - Street 1:373 EDWIN DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-4522
Practice Address - Country:US
Practice Address - Phone:757-301-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRBT-22-240963106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician