Individual
CORY BOUNPHAKDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
525 N TRYON ST STE 1600, CHARLOTTE, NC 28202-0213
(855) 832-6727
(772) 675-9100
Mailing address
1117 MEADOWBROOK LN SW, CONCORD, NC 28027-1739
(860) 514-9326
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/19/2026
Last updated
01/19/2026
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