Individual
MAGGIE MARIE DICESARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4801 EDWARDS MILL RD, RALEIGH, NC 27612-4417
(919) 787-0777
Mailing address
6193 NC HIGHWAY 102 W, CHOCOWINITY, NC 27817-9108
(252) 531-5190
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12401
NC
Other
Enumeration date
08/22/2020
Last updated
08/22/2020
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