Provider Demographics
NPI:1528667243
Name:AVERY, RASHONNA (MBA, LRT/CTRS, NDP,)
Entity type:Individual
Prefix:
First Name:RASHONNA
Middle Name:
Last Name:AVERY
Suffix:
Gender:F
Credentials:MBA, LRT/CTRS, NDP,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 WRENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-3384
Mailing Address - Country:US
Mailing Address - Phone:919-357-6830
Mailing Address - Fax:
Practice Address - Street 1:508 FULTON ST # 117C
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3875
Practice Address - Country:US
Practice Address - Phone:919-286-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist