Provider Demographics
NPI:1528520673
Name:ETRINGER, JAMIE B (RBT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:B
Last Name:ETRINGER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:BYRUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:702 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-9447
Mailing Address - Country:US
Mailing Address - Phone:252-299-4411
Mailing Address - Fax:
Practice Address - Street 1:210 TALS ROCK WAY STE 3
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-1919
Practice Address - Country:US
Practice Address - Phone:919-745-8892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NC1-21-54226103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-19-79932OtherBEHAVIOR ANALYST CERTIFICATION BOARD (BACB)