Individual
MS. KATHLEEN WAGNER CORBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2303 CLUB RD, CHARLOTTE, NC 28205-3673
(704) 906-9574
Mailing address
2303 CLUB RD, CHARLOTTE, NC 28205-3673
(704) 906-9574
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6987
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6987
OCCUPATIONAL THERAPY LICENSE #
NC
Enumeration date
10/08/2009
Last updated
04/27/2022
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