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Individual

MRS. HALEY ELISE TUCKER WATKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
561 N POLK ST, PINEVILLE, NC 28134-8563
(704) 667-8470
(704) 667-8471
Mailing address
1100 BLYTHE BLVD, CHARLOTTE, NC 28203-5814
(704) 355-4645
(704) 355-4541

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
9991
NC

Other

Enumeration date
09/25/2015
Last updated
09/25/2015
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