Healthcare Provider Details

I. General information

NPI: 1104738103
Provider Name (Legal Business Name): SENAIYE BURTON RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 ROZZELLES FERRY RD
CHARLOTTE NC
28208-3233
US

IV. Provider business mailing address

5909 FARM POND LN APT 303
CHARLOTTE NC
28212-1703
US

V. Phone/Fax

Practice location:
  • Phone: 877-418-2978
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-531624
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: