Individual
AMANDA ELAINE BURLESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3800 SHAMROCK DR, CHARLOTTE, NC 28215-3220
(704) 532-7000
Mailing address
11834 SHOEMAKER CT, CHARLOTTE, NC 28270-1570
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
8371
NC
Other
Enumeration date
06/18/2012
Last updated
12/07/2012
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