Individual
RENEE MARCIELE PEROVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1700 PAMALEE DR, FAYETTEVILLE, NC 28301-2824
(910) 488-2295
Mailing address
408 BRISTLECONE RD, FAYETTEVILLE, NC 28311-7697
(951) 870-5501
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
9389
NC
224Z00000X
Occupational Therapy Assistant
OTA001688
GA
Other
Enumeration date
11/02/2013
Last updated
07/22/2015
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