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Individual

DR. MATTHEW S. BURGESS LEARY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1923 J N PEASE PL, SUITE 204, CHARLOTTE, NC 28262-4513
(704) 503-3535
(704) 593-5555
Mailing address
1923 J N PEASE PL, SUITE 204, CHARLOTTE, NC 28262-4513
(704) 503-3535
(704) 593-5555

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3953
NC
103TC0700X
Clinical Psychologist
3953
NC
103TC2200X
Clinical Child & Adolescent Psychologist
103TF0000X
Family Psychologist

Other

Enumeration date
05/18/2007
Last updated
06/08/2010
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