Organization
DEVELOPMENTAL THERAPY ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG STIVLAND MBA, MHA, OTR/L (BUSINESS MANAGER)
(919) 493-7002
Entity
Organization
Contact information
Practice address
3514 UNIVERSITY DR, OFFICE #8, DURHAM, NC 27707-6247
(919) 493-7002
(919) 403-1407
Mailing address
3514 UNIVERSITY DR, OFFICE #8, DURHAM, NC 27707-6247
(919) 493-7002
(919) 403-1407
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0199H
BCBS NC GROUP NUMBER
NC
05
—
720199H
—
NC
Enumeration date
08/29/2006
Last updated
07/19/2013
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