Individual
MISS MARIANA L PESANTEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 748-0516
(980) 389-0044
Mailing address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 748-0516
(980) 389-0044
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
015089-1
NY
225X00000X
Occupational Therapist
Primary
6246
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7211258
—
NC
05
—
7301953
—
NC
Enumeration date
01/22/2007
Last updated
02/02/2017
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