Individual
GENESIS DAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
420 HAWTHORNE LN, CHARLOTTE, NC 28204-2312
(704) 780-4271
Mailing address
2301 TANFIELD DR, MATTHEWS, NC 28105-0814
(786) 610-9538
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021741600
—
FL
Enumeration date
03/19/2018
Last updated
12/13/2023
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