Provider Demographics
NPI:1487455770
Name:YARBOROUGH, KHALEA
Entity type:Individual
Prefix:
First Name:KHALEA
Middle Name:
Last Name:YARBOROUGH
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 1:728 BREEDERS CUP DR
Mailing Address - Street 2:
Mailing Address - City:WHITSETT
Mailing Address - State:NC
Mailing Address - Zip Code:27377-8008
Mailing Address - Country:US
Mailing Address - Phone:336-524-3264
Mailing Address - Fax:
Practice Address - Street 1:728 BREEDERS CUP DR
Practice Address - Street 2:
Practice Address - City:WHITSETT
Practice Address - State:NC
Practice Address - Zip Code:27377-8008
Practice Address - Country:US
Practice Address - Phone:336-524-3264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical