Individual
ANISA CHUN KONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L, CHT
Contact information
Practice address
2230 E FRANKLIN BLVD STE 100, GASTONIA, NC 28054-4983
(704) 830-6168
(704) 853-1809
Mailing address
2230 E FRANKLIN BLVD STE 100, GASTONIA, NC 28054-4983
(704) 830-6168
(704) 853-1809
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
888
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G56017
—
NC
Enumeration date
07/22/2008
Last updated
11/03/2019
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