Provider Demographics
NPI:1053038844
Name:URMANCHE, ADELYA (PHD)
Entity type:Individual
Prefix:DR
First Name:ADELYA
Middle Name:
Last Name:URMANCHE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 ELI HARTLEY DR APT 104
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-3794
Mailing Address - Country:US
Mailing Address - Phone:828-278-9107
Mailing Address - Fax:
Practice Address - Street 1:222 JOYCE LAWRENCE LN
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28608-1304
Practice Address - Country:US
Practice Address - Phone:828-278-9107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6650103TH0100X, 103TC0700X
NY026093103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103T00000XBehavioral Health & Social Service ProvidersPsychologist