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Individual

MS. ANITA FAYE MCKINNEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
630 N FODALE AVE, SOUTHPORT, NC 28461-3538
(910) 457-0830
Mailing address
2245 BOONES NECK RD SW, SUPPLY, NC 28462-6223
(910) 842-6587

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8493
NC

Other

Enumeration date
05/06/2013
Last updated
05/06/2013
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