Provider Demographics
NPI:1992213862
Name:LAMPKIN, CHERRY ANN PUNTANAR
Entity type:Individual
Prefix:
First Name:CHERRY ANN
Middle Name:PUNTANAR
Last Name:LAMPKIN
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 1:1824 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:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-12
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-18-47579106S00000X
NCA1276106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician