Provider Demographics
NPI:1609615491
Name:ROBERTS, RANESHA
Entity type:Individual
Prefix:
First Name:RANESHA
Middle Name:
Last Name:ROBERTS
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 1:3349 VARDAMAN AVE
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-9696
Mailing Address - Country:US
Mailing Address - Phone:910-303-3337
Mailing Address - Fax:
Practice Address - Street 1:421 FAYETTEVILLE ST STE 1100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27601-3000
Practice Address - Country:US
Practice Address - Phone:774-182-9788
Practice Address - Fax:866-500-2186
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst