Provider Demographics
NPI:1316513492
Name:BURLEY, CYNTHIA D
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:D
Last Name:BURLEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:D
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:634 RIVER HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9055
Mailing Address - Country:US
Mailing Address - Phone:704-945-4477
Mailing Address - Fax:
Practice Address - Street 1:634 RIVER HWY STE 300
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9055
Practice Address - Country:US
Practice Address - Phone:704-945-4477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-31
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAS-6979OtherSTATE OF LOUISIANA - LINE TECH REGISTRATION NUMBER
RBT-21-168080OtherREGISTER BEHAVIOR TECHNICIAN ID