Individual
MRS. DONNA KAY TICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
901 BETHESDA RD, WINSTON SALEM, NC 27103-3015
(336) 768-2211
Mailing address
5333 SUMMIT HEIGHTS DR, WINSTON SALEM, NC 27104-4480
(336) 794-0585
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2617
NC
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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