Individual
MS. LESLIE MIZE KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTL
Contact information
Practice address
8812 KAPHEIM CT, CHARLOTTE, NC 28273-8832
(404) 695-9237
Mailing address
8812 KAPHEIM CT, CHARLOTTE, NC 28273-8832
(404) 695-9237
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7121
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7302161
—
NC
Enumeration date
01/15/2007
Last updated
04/20/2009
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