Individual
MADISON KATE WALSTON
Active
Individual
MADISON KATE WALSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
15060
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15060
NORTH CAROLINA STATE LICENSE BOARD
NC
Enumeration date
09/21/2022
Last updated
01/23/2024
Update your record
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