Individual
MRS. RITA BIANCO PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
205 SE SERVICE RD, SOUTHERN PINES, NC 28387-5057
(910) 684-4570
Mailing address
1126 7 LKS N, WEST END, NC 27376-9756
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5305
NC
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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