Individual
MRS. MICHELLE R. WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
110 CORNING RD, CARY, NC 27518-9229
(919) 431-7400
Mailing address
7116 FUGATE CT, RALEIGH, NC 27617-7696
(919) 412-4651
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
3834
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11973
BLUE CROSS
NC
Enumeration date
03/05/2007
Last updated
04/16/2026
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