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Organization
OCTAVIA & MAIN, LLC
Active
Organization
OCTAVIA & MAIN, LLC
Active
Other names
Thriveworks
Organization subpart
No
Provider details
NPI number
Authorized official
MARC A. BROOKS (MEMBER)
(919) 986-2962
Entity
Organization
Contact information
Practice address
1131 QUEENSBOROUGH BLVD STE 100, MT PLEASANT, SC 29464-5430
(843) 606-6223
Mailing address
910 STRATHORN DR, CARY, NC 27519-8842
(919) 986-2962
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
—
NULL
225XM0800X
Mental Health Occupational Therapist
Primary
—
—
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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