Individual
TIMOTHY GORDON HERLIHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT/L
Contact information
Practice address
3514 HAYDEN DR, CHARLOTTE, NC 28269-1239
(704) 281-8813
(704) 598-7709
Mailing address
3514 HAYDEN DR, CHARLOTTE, NC 28269-1239
(704) 281-8813
(704) 598-7709
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0637
NC
Other
Enumeration date
08/25/2009
Last updated
09/15/2010
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