Most Relevant Information
Provider Data
| NPI Number: | 1003305863 |
| Provider Name: | KELSEY BURGESS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-16-20941 |
Most Important Dates
| Enumeration Date: | 05/08/2018 |
| Last Updated: | 05/08/2018 |
Provider Practice Location
2301 CROWNPOINT EXECUTIVE DR STE E
CHARLOTTE
NC
282276725
Practice Location Phone/Fax
| Phone: | 7047088314 |
| Fax: | 7047088315 |
Provider Mailing Location
2301 CROWNPOINT EXECUTIVE DR STE E
CHARLOTTE
NC
282276725
Provider Mailing Phone/Fax
| Phone: | 7047088314 |
| Fax: | 7047088315 |