Individual
JUSTICE DIVINE NEWSOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1317 LEGACY FALLS DR APT 207, WAKE FOREST, NC 27587-1794
(910) 391-4989
Mailing address
1317 LEGACY FALLS DR APT 207, WAKE FOREST, NC 27587-1794
(910) 391-4989
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
05/06/2024
Last updated
05/08/2024
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