Individual
MRS. LISA FERGUSON MINERICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4800 S CROATAN HWY, NAGS HEAD, NC 27959-9704
(252) 449-4560
Mailing address
1 FERN LN, SOUTHERN SHORES, NC 27949-3719
(301) 785-0556
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
7631
NC
Other
Enumeration date
11/08/2020
Last updated
11/08/2020
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