Individual ProviderMia SturdivantBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address421 Fayetteville St Ste 110, Raleigh, NC 27601-1792(877) 418-2978PECOS EnrollmentBased on the most recent information from CMS, provider Mia Sturdivant does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1245057355Provider TypeIndividualFull NameSturdivant, MiaGenderFemaleSole ProprietorNoEnumeration Date9/21/2024Last Updated9/21/2024Contact InformationPractice LocationPractice Address421 Fayetteville St Ste 110, Raleigh, NC 27601-1792Phone(877) 418-2978FaxUnlisted FaxMailing LocationMailing Address350 Fairway Dr Ste 101, Deerfield Beach, FL 33441-1834Phone(877) 418-2978FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer