Provider Demographics
NPI:1629644059
Name:GONZALEZ FERREIRA, REBECCA (MS, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:GONZALEZ FERREIRA
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 MARSHLANE WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-4277
Mailing Address - Country:US
Mailing Address - Phone:910-745-3655
Mailing Address - Fax:
Practice Address - Street 1:101 N TRYON ST STE 112
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28246-0104
Practice Address - Country:US
Practice Address - Phone:877-651-3287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC726103K00000X
NC1-21-56320103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst