Individual
MISS MINDY LAUREN ROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
380 COUNTRY DAY RD, GOLDSBORO, NC 27530-8857
(919) 580-1060
Mailing address
3545 WILLIE MEASLEY RD, LA GRANGE, NC 28551-8010
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6391
NC
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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