Individual
JUDITH A SPAVENTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT,OTR/L
Contact information
Practice address
106 LOCOMOTIVE LN, UNIT 202, MOORESVILLE, NC 28115-8522
(828) 446-9463
Mailing address
106 LOCOMOTIVE LN, UNIT 202, MOORESVILLE, NC 28115-8522
(828) 446-9463
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
6866
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548420862
BCBS
NC
05
—
7302089
—
NC
Enumeration date
06/10/2008
Last updated
04/23/2020
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