Individual
MRS. MARISAN VAN DYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
137 OVERHILL DR, SUITE 102, MOORESVILLE, NC 28117-8006
(704) 799-6824
Mailing address
111 ALAMEDA CIR, MOORESVILLE, NC 28117-4363
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2980
NC
225XP0200X
Pediatric Occupational Therapist
Primary
2980
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7301685
—
NC
Enumeration date
04/25/2006
Last updated
09/11/2025
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