Individual
JONAH LYTCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
142 BERMUDA VILLAGE DR, ADVANCE, NC 27006-7867
(336) 998-6763
Mailing address
935 BOYER DR, CLEMMONS, NC 27012-9476
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5189
NC
Other
Enumeration date
03/20/2019
Last updated
03/20/2019
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