Somsanouk Jean Roberts | Raleigh, NC • PECOS Search

Somsanouk Jean Roberts

Behavior Technician

Behavioral Health & Social Service Providers

421 Fayetteville St, Raleigh, NC 27601-1792

(888) 880-9270 (253) 651-3327

PECOS Enrollment

Based on the most recent information from CMS, provider Somsanouk Jean Roberts does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1649745126
Provider Type
Individual
Full Name
Roberts, Somsanouk Jean
Gender
Female

Sole Proprietor
No
Enumeration Date
10/10/2018
Last Updated
10/10/2018

Contact Information

Practice Location

421 Fayetteville St, Raleigh, NC 27601-1792

Unlisted Fax

Mailing Location

122 Terrier Way, Raeford, NC 28376-7963

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106S00000X Primary	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer