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Individual

MS. LESLIE BETH HATHAWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD, MS, OTRL

Contact information

Practice address
5209 NEUSE TAVERN CT, RALEIGH, NC 27616-7889
(919) 578-3285
(919) 999-3483
Mailing address
5209 NEUSE TAVERN CT, RALEIGH, NC 27616-7889
(919) 578-3285
(919) 999-3483

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4887
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
139CO
BCBS
NC
Enumeration date
03/16/2007
Last updated
05/21/2014
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