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Organization
PRESTIGE CHILDRENS TRAUMA CHILD DEVELOPMENT CORP
Active
Organization
PRESTIGE CHILDRENS TRAUMA CHILD DEVELOPMENT CORP
Active
Other names
PRESTIGE CHILDRENS TRAUMA CDC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WANDA MARIE BURNS (PASTORAL COUNSELOR)
(888) 779-1232
Entity
Organization
Contact information
Practice address
3030 GLEN LAUREL DR, CONCORD, NC 28025-1614
(980) 219-0907
Mailing address
57 UNION ST S STE 1221, CONCORD, NC 28025-5009
(980) 292-2204
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
305S00000X
Point of Service
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
Other
Enumeration date
01/30/2023
Last updated
04/25/2023
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