Provider Demographics
NPI:1679805717
Name:LEDAY, ROSE MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:MARIE
Last Name:LEDAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11600 NORTH COMMUNITY HOUSE ROAD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-1885
Mailing Address - Country:US
Mailing Address - Phone:704-927-5885
Mailing Address - Fax:866-372-5885
Practice Address - Street 1:3440 TORINGDON WAY
Practice Address - Street 2:SUITE #205
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3190
Practice Address - Country:US
Practice Address - Phone:704-927-5885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-29
Last Update Date:2015-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3909103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical