Individual
MARIE ETHEL WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
550 GLENWOOD DR, MOORESVILLE, NC 28115-2876
(704) 664-7494
Mailing address
123 N CROMWELL DR, MOORESVILLE, NC 28115-2979
(570) 407-2329
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7262
NC
Other
Enumeration date
06/03/2008
Last updated
09/13/2013
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