Individual
TYQWISHA MACKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTL
Contact information
Practice address
1500 SAWMILL RD, RALEIGH, NC 27615-4320
(910) 891-1599
Mailing address
1500 SAWMILL RD, RALEIGH, NC 27615-4320
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
16393
NC
Other
Enumeration date
11/06/2023
Last updated
04/01/2026
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