Individual
LESLIE BURNSIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6307 HONEGGER DR, CHARLOTTE, NC 28211-4716
(704) 442-0522
Mailing address
6307 HONEGGER DR, CHARLOTTE, NC 28211-4716
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2860
NC
Other
Enumeration date
06/18/2007
Last updated
07/08/2007
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