Individual
JESSICA FAYE-GOMEZ HADDAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7022 SARDIS RD, CHARLOTTE, NC 28270-6058
(704) 960-9254
Mailing address
119 YORK AVE, KANNAPOLIS, NC 28083-4419
(704) 960-9254
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12596
NC
Other
Enumeration date
12/05/2019
Last updated
12/05/2019
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