Individual
MS. KRISTIN DANIELLE BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., OTR/L
Contact information
Practice address
211 W MATTHEWS ST, SUITE 101, MATTHEWS, NC 28105-1309
(980) 245-2340
(980) 245-2333
Mailing address
2439 EATON RD, CHARLOTTE, NC 28205-7424
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
8051
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7302345
—
NC
05
—
TH2467
—
SC
Enumeration date
10/25/2011
Last updated
07/01/2016
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