Individual
KELLY LAWLER WEYNAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1016 EUCLID AVE, CHARLOTTE, NC 28203-4520
(704) 807-5699
(704) 807-5699
Mailing address
9611 BROOKDALE DR STE 100-122, CHARLOTTE, NC 28215-8719
(704) 807-5699
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
11333
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000034225830
DRIVERS LICENSE
NC
Enumeration date
01/12/2018
Last updated
01/12/2018
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