Provider Demographics
NPI:1558110569
Name:BURTON, MEASHIA (RBT)
Entity type:Individual
Prefix:
First Name:MEASHIA
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1824 HARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-3951
Mailing Address - Country:US
Mailing Address - Phone:910-687-4099
Mailing Address - Fax:910-302-3845
Practice Address - Street 1:2533 RAEFORD RD STE D
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5094
Practice Address - Country:US
Practice Address - Phone:910-687-4099
Practice Address - Fax:910-302-3845
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician