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Individual

LEILANI VICTORIA AYAKO DOI MAYBIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
1087 13TH ST SE, HICKORY, NC 28602
(828) 267-1688
Mailing address
1087 13TH ST SE, HICKORY, NC 28602-4165

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
17640
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
38131013
DRIVER'S LICENSE
NC
Enumeration date
01/04/2018
Last updated
08/21/2018
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