Individual
TESSARAH DALLEAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 E KINGS HWY, EDEN, NC 27288-5239
(336) 623-9712
Mailing address
205 E KINGS HWY, EDEN, NC 27288-5239
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
9344
NC
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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