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Individual

CANDANCE CODE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3001 SPRING FOREST RD, RALEIGH, NC 27616-2815
(888) 440-4987
Mailing address
202 ROCKBROOK CT, GREER, SC 29650-4580
(662) 719-9211

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4393
SC

Other

Enumeration date
04/22/2008
Last updated
01/24/2020
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