Individual
KAITLYN MARIE ETHERIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
58 PHYSICIANS DR NW, SUPPLY, NC 28462-4215
(910) 755-5437
Mailing address
30 TALFORD DR, WENDELL, NC 27591-7586
(919) 880-0791
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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