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Individual

MS. DIANE BAILEY GOLLOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
5778 NC HWY 88 WEST, WARRENSVILLE, NC 28693-9209
(336) 384-4500
Mailing address
330 LITTLE LAUREL RD, CRESTON, NC 28615-8923
(336) 385-2122

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4499
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7301630
NC
Enumeration date
03/12/2007
Last updated
07/09/2007
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