Individual
CORRINE LOUISE MFUNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
116 LANE DR, TRINITY, NC 27370-9343
(336) 434-1706
Mailing address
5167 FARLOW ST, ARCHDALE, NC 27263-4327
(336) 259-8810
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7751
NC
Other
Enumeration date
11/22/2012
Last updated
11/22/2012
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