Individual
CHANTALE POULIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
610 W MORGAN ST APT 111, DURHAM, NC 27701-2175
(858) 699-3584
Mailing address
610 W MORGAN ST APT 111, DURHAM, NC 27701-2175
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6829
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6829
NC OT LICENSE
NC
Enumeration date
08/21/2008
Last updated
08/21/2008
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