Individual
MARY IVEY LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
A7606
NC
225200000X
Physical Therapy Assistant
Primary
A7606
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
09/06/2022
Last updated
09/06/2022
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