Individual
CARLY NICOLE PELLERIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 824-4999
Mailing address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 824-4999
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
13953
NC
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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