Organization
STIMULATE YOUR CHILD DEVELOPMENTAL THERAPY PLLC
Active
Organization
STIMULATE YOUR CHILD DEVELOPMENTAL THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GEORGIANA C LUKE-HENRY OTR/L (PRESIDENT)
(704) 975-2840
Entity
Organization
Contact information
Practice address
1646 RUSTIC ARCH WAY, HUNTERSVILLE, NC 28078-3628
(704) 975-2840
(704) 998-8907
Mailing address
1646 RUSTIC ARCH WAY, HUNTERSVILLE, NC 28078-3628
(704) 975-2840
(704) 998-8907
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7509
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134276843
NPI
NC
05
—
7302306
—
NC
Enumeration date
11/17/2016
Last updated
01/11/2019
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