Individual
FELICIA VANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
135 HUNTING RIDGE RD APT 900, ROANOKE RAPIDS, NC 27870-4127
(434) 594-0228
Mailing address
135 HUNTING RIDGE RD APT 900, ROANOKE RAPIDS, NC 27870-4127
(434) 594-0228
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
8810
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12345
OCCUPATIONAL THERAPY
—
Enumeration date
11/12/2019
Last updated
11/12/2019
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