Individual
DIANA MARIE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1341 PARADISE RD, EDENTON, NC 27932-8503
(252) 482-7481
Mailing address
415 WASHINGTON ST, PLYMOUTH, NC 27962-1823
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
15763
NC
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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